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Home My WebLink About2301 Bahamasr UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Hazardous Materials Business Plan Inspection c 1�Ycs ✓ (LnnS/ BAKERSFIELD FIRE DEPT. `� Prevention Services 2101 H Street 1E,i Bakersfield, CA 93301 (� Tel.: (661)326-3979 v, Fax: (661)852-2171 FACILITY NAME n ADDRESS FACILITY CONTACT NSPECTION DATE NSPECTION TIME HONE NO. O OF EMPLOYEES USINESS ID NUMBER onsont to Inspect Name?Itle Section 1: Business Plat and Inventory Program ROUTINE ❑ COMB14D ❑ JOINTAGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ REINSPECTION C V G-G.prp. OPERATION lb -violation; 1,11 Minor CERS Violation COMMENT CAPPROPRIATE PERMIT ON HAND (BMC: 15.63080) 3010001 r OERS INFORMATION ENTERED& UPDATED ANNUALLY (CCR:2729.1) 321 W43 C VISIBLEADDRESS (CFC: 505.1, BMC: 16.62.020) C CORRECTOCCUPANCY (CBC: 401) rVERIFICATION OF INVENTORY MATERIALS (CCR: 2729,3) 1010004 C VERIFICATION OF QUANTITIES (CCR: 2729.4) 1010006 C VERIFICATION OF LOCATION (CCR: 27292) C PROPER SEGREGATION OF MATERIAL (CFC: 2]04.1) C VERIFICATION OF SES AVAIIABILITY (CCR: 2292(3)(b)) C VERIFICATION OF HAZ MAT TRANJING (CCR: 2]32) iWo002 VERIFICATUNOFABATEMENTSUPPUES&PROCEOURES (CCR:2731(C)) EMERGENCY PROCEDURES ADEQUATE (CCR'. 27311 1010010 CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 27035) 3030007 HouSEKEEPWG (CPC: 304.11 FIRE PROTECTION (CFC: 903 & 906) 3030032 SITE DIAGRAM ADEQUATE &ON NAND (CCR: 27292) 1010005 NY HAZARDOUS WASTE ON SITE? ❑ YES 0 NO t ofltecel t a Plei n: II,Xln i I I P INSPECTION B RIULTIONS: Correct Ne violadorax) toted above by Within 5 days of correcting an of the violedom', sign am mom a copy of this page to: Bakersfield Fite Dept., Prevention Services. 2 10 1 H Street, California 93301 White-Rauncs Cryry Yellow- Station Copy Pink- Prevention Services Sipstsre Ithat all violations Mve bttn corrected ac ni Date F=155 (ACV 9POP) FACILITY NAME,.. ° INSPECTION DATE INSPECTION TIME V= violation; I,11Minor ADDRESS,-, COMMENT PHONE NO., NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER Consent to Inspect Name /Title APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) 3010001 C- V: C =Compliance O P E RATE O N C E RS V= violation; I,11Minor Violation COMMENT APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) 3010001 CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1) 3210043 �. VISIBLE ADDRESS . (CFC: 505.1,.BMC: 15.52.020) .* 5 CORRECT OCCUPANCY (CBC: 401) VERIF'`w.. (CCR: „_ [CATION OF. INVENTORY, MATERIALS CCR: 2729.3 1010004 ` VERIFICATION OF QUANTITIES (CCR: 2729.4) ' 1010006 VERIFICATION OF LOCATION (CCR: 2729.2) PROPER SEGREGATION OF MATERIAL (CFC: 2704.1) VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b)) VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) 1020002 .' VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731.(c)) EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) 1010010 ` CONTAINERS PROPERLY LABELED (CCR: 66,262.34(o, CFC: 2703.5). 3030007 HOUSEKEEPING (CFC: 304.1) FIRE PROTECTION (CFC:. 903 & 906) 3030032 ' SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) 1010005 ANY HAZARDOUS WASTE ON SITE? 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Mid sseuisn8 s'siaalsw snOPJMBH : L N 0113 3 S 1.511 )i33H3 NtO1.LOUSN1- WdUJIOHd ®31d1Nn z t: �... 0,..,.._ r�k..... �uw^•. n. iE. alaea..f t. �,` �"'`:. u:' 4' 1�e�1�� ..:NSiL`idSPE1i"e+�r�"'.iu°' e�'rii�N'Y J.3. i ••r;” ""V�� 4 �7d�':,aG�A . 4 BAKERSFIELD FIRE DEPT. aRTM Prevention Services UNIFIED. PROGRAM INSPECTION CHECKLIST r 2101 HStreet ii� ...:. .. Bakersfield, CA 93301 Haz-Mat Business Plan and Inventory Program Tel.: (661) 326 -3979 r Fax: (661) 852 -2171 FACILITY NAME INSPE9TION DATE INSPECTION TIME ADDRESS PF O E NO.' NO OF MPLOYEES FACILITY,eONTACT BUSINESS! ID [NUMBER J F Consent to . spect Na /Title [� Z ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT E3 RE- INSPECTION C v ( C =Compliance) OPERATION V= Violation COMMENTS BAKERSFIELD FIRE DEPT. aRTM Prevention Services UNIFIED. PROGRAM INSPECTION CHECKLIST r 2101 HStreet ii� ...:. .. Bakersfield, CA 93301 Haz-Mat Business Plan and Inventory Program Tel.: (661) 326 -3979 r Fax: (661) 852 -2171 FACILITY NAME INSPE9TION DATE INSPECTION TIME ADDRESS PF O E NO.' NO OF MPLOYEES FACILITY,eONTACT BUSINESS! ID [NUMBER J F Consent to . spect Na /Title [� Z ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT E3 RE- INSPECTION • . Correct the violation(s) noted above by • Within 5 days of correcting all of the violations, sign and return a copy of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 White —Business Copy Yellow — Business, Copy to be Sent in after return to Compliance Signature (that all violations have been corrected as noted) Date. Pink Prevention Services Copy' FD2155 (Rev 1/14) C v ( C =Compliance) OPERATION V= Violation COMMENTS ❑ VISIBLE ADDRESS (CFC: 505.1, BMC:15.52.020) ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H &S 25404(e) ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) 7 ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) ❑ VERIFICATION OF LOCATION (CCR: 2729.2) ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1) ❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b)) ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) .000 ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c)) ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) J ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) ❑ ❑ HOUSEKEEPING (CFC: 304.1) ❑ FIRE PROTECTION (CFC: 903 & 906) ,eve❑ ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO Explain: i nature of Recei t: r POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: w • . Correct the violation(s) noted above by • Within 5 days of correcting all of the violations, sign and return a copy of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 White —Business Copy Yellow — Business, Copy to be Sent in after return to Compliance Signature (that all violations have been corrected as noted) Date. Pink Prevention Services Copy' FD2155 (Rev 1/14) F~ .-`~' ll. -- '~ - - aF -- - - ~> --- ,~'~- ~ ~~~ ~. _- = - ~ --- UNIFIED PROGRAM INSPECTION CHECKLIST. SECTION 1: Business Plan and Inventory Program ~" Prevention Services B A e R s r, D 900 Truxtun Ave., Suite 210 FIRE ~ Bakersfield; CA 93301 aRrM Tel:: (661) 326-3979 . Fax: (661) 872-2171 / ~ FACILITY NAME INSPECTION DATE INSPECTIO N TIME ' ,[~ /~1 / ^- /'l l./~ ~~ r ~ '~ ~ ( `~ V - ADDRESS PHONE NO. NO OF E OYEES ~ ~ €~. 3 - l~~ t FACILITY CONTACT BUSINESS ID NUMBER - ~S~ ~ 15-021- ~ prJ g Z ~ Section 1: Business Plan and Inventory Program ~~~'~ 1~. ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIf12SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY 0 2006 ^ VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL L~/^ VERIFICATION OF MSDS AVAILABILITY G ~ ^ VERIFICATION OF HAZ MAT TRAINING ' ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~^ EMERGENCY PROCEDURES ADEQUATE .I~ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS~STE ON SITE? j_~YES ^ NO EXPLAIN:. l~ QUEST ONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~c Inspector (Please Print) Fire Prevention / 1'~ In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 t KERN RADIOLOGY Manager JOYCE AYERS Location: 2301 BAHAMAS DR City BAKERSFIELD SiteID: 015-021-000821 BusPhone: (661) 326-9600 Map 102 CommHaz High Grid: 26D FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: CAL000066021 SIC Code:8011 DunnBrad:77-025-1480 Emergency Contact / Title Emergency Contact / Title JOYCE AYERS / MANAGER JERRY STURZ / CEO ~~I.7~~GQ~ Business Phone: (661) 328-6454x Busin ess Phone: (661) '''~a°-4^~~~ 24-Hour Phone (661) 326-9600x 24-Ho ur Phone (661) 326-9600x Pager Phone (661) 342-6212x Pager Phone (661) 619-7275x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact JERRY STURZ Phone : ( 661) 3-2~-G4-5-~x MailAddr: 2301 BAHAMAS DR State • CA "3~5 ' 3Z ~o City BAKERSFIELD Zip 93309 Owner KERN RADIOLOGY MEDICAL GROUP INC Phone : ( 661) 3~--3-9~8-~-x Address 2301 BAHAMAS DR State: CA 32C~° lava City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN De^ed on rry inquiry of those indiuiduais „ling the information, I certify h ~a regMC;~~i~,iu ,,r o nalty of ia~ that I have personally unr9or pe ex2.^"ir;ed and a ~ nformationo is true, il f the ~ e l, acc~ raie, and compie O 1~ ©~ -- Date Signature EMT'p A U G 0 9 2Q07 -1- 07/12/2007 ~J ~ F KERN RADIOLOGY SiteID: 015-021-000821 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP DEVELOPER DH L 85.00 GAL Hi FIXER DH L 85.00 GAL Hi HELIUM F P IH G 405.00 FT3 Min WASTE FIXER R L 50.00 GAL Min -2- 07/12/2007 ~. -3- 07/12/2007 5 r F KERN RADIOLOGY SiteID: 015-021-000821 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DEVELOPER Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 1310-58-3 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture Below Ambient Below Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 85.00 GAL 85.00 GAL 85.00 GAL riAGKKL V U.7 1, V 1~1Y V1VL' 1V 1.7 %Wt. RS CAS# 89.00 Water No 7732185 3.00 Potassium Sulfite No 10117381 2.00 Hydroquinone (EPA) No 123319 3.00 Sodium Sulfite No 7757837 2.00 Potassium Hydroxide No 1310583 1.00 Potassium No rlr~at~tcL r~aa~aaln~ty 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Hi -4- 07/12/2007 r F KERN RADIOLOGY ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME FIXER Location within this Facility Unit STATE TYPE PRESSURE _ Liquid TMixture Below Ambient SiteID: 015-021-000821 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7783-43-3 TEMPERATURE CONTAINER TYPE Below Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 85.00 GAL 85.00 GAL _ 85.00 GAL tiL-~GHKLV U.7 1..V1~lYV1VL" 1V 1 J %Wt. RS CAS# 90.00 Water No 7732185 8.00 Ammonium Thiosulfate No 7783188 1.00 Sodium Sulfite No 7757837 1.00 Aluminum Sulfate No 10043013 t1HG1~K1J k~JJL" JJ1~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Hi ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit MRI/ISOLATED RM STATE TYPE PRESSURE _ Gas Pure. Above Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7440-59-7 TEMPERATURE CONTAINER TYPE Ambient FIXED PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Co405100rFT3 Daily 405100m FT3 I Daily 405r00e FT3 P1HGH.KLVU.7 lrVl"lYV1V1;1V 1.7 %wt. Rs cAS# 100.00 Helium No 7440597 riHGEittL 1i. 7.7J;J.71~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 07/12/2007 5' F KERN RADIOLOGY ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit AT ~ TREATMENT UNITS ON SITE SiteID: 015-021-000821 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# Liquid TWaste ~ Ambient~E ~ AmbientT~E ~ PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 5.00 GAL 50.00 GAL 30.00 GAL - r1r~~r~tcLVUS wl~iruiv~iv-l~ owt. Rs cAS# Silver No 7440224 riAGAKL H55li~~1~11;1V'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -6- 07/12/2007 F KERN RADIOLOGY SiteID: 015-021-000821 Fast Format ~ Notif./Evacuation/Medical Overall Site Agency Notification 03/27/2006 CALL 911. GENERAL ELECTRIC - 800-437-1171 - 360 W BEDFORD AVE 105 FRESNO CA 93711 OFFICE OF EMERGENCY SERVICES - 800-852-7550. Employee Notif./Evacuation 09/28/2000 PUBLIC ADDRESS SYSTEM AND FIRE ALARM SYSTEM. ALL EMPLOYEES TO EVACUATE BLDG AT EXIT NEAREST THEIR LOCATION. GATHER AT ~1 EMPLOYEE COUNT. ~~ ~c~:~. 0 ~~C~.~rr~~ ~~ Jam( Cl~~s Public Notif./Evacuation 09/28/2000 RECEPTIONISTS RESPONSIBLE FOR PATIENTS IN WAITING ROOM. EXPEDITORS RESPOSIBLE FOR PATIENTS IN DRESSING AREAS. TECHNOLOGISTS RESPONSIBLE FOR PATIENTS IN EXAM ROOMS. Emergency Medical Plan 03/27/2006 PHYSICIAN ON PREMISES AT ALL TIMES DURING OPEN HOURS. FULL-TIME NURSE ON STAFF. HALL AMBULANCE - 661-327-4111. LIBERTY AMBULANCE - 661-395-1111. MEMORIAL, MERCY HOSPITAL OR ER. -7- 07/12/2007 . ;• F KERN RADIOLOGY SitelD: 015-021-000821 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ . Release Prevention 09/28/2000 HELIUM IS STORED IN SEPARATE ISOLATED ROOM. WASTE IS STORED IN RED AIR TIGHT HAZARDOUS CONTAINERS. PROCESSING CHEMICALS IN PLASTIC CONTAINERS. SPRINKLER SYSTEM THROUGHOUT BLDG. SAFETY TRAINING MANUAL FOR EMPLOYEES. Release Containment 03/27/2006 HAVE 50 LBS OF KITTY LITTER ON PREMISES AT ALL TIME. HAVE PERMANENT HAZARDOUS WASTE CONTAINMENT AND CLEAN-UP KIT. Clean Up 09/28/2000 SPREAD KITTY LITTER, USE SQUEEGEE AND DUST PAN. INSERT IN HAZARDOUS WASTE CONTAINER. HAVE CONTRACT WITH HAZARDOUS WASTE DISPOSAL COMPANY, (BFI MEDICAL WASTE SYSTEMS) TO REMOVE HAZARDOUS WASTE. Other Resource Activation -8- 07/12/2007 l ~~ v F KERN~RADIOLOGY SiteID: 015-021-000821 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ Special Hazards 03/27/2006 ~ RADIOISATOPES ON HAND - RADIATION HAZARD. CONTAINERS ARE USED FOR ALL RADIOISOTOPES AND HAULED OFF-SITE BY BFI MEDICAL WASTE SYSTEM AND CARDINAL HEALTH. Utility Shut-Offs 03/27/2006 A) GAS - SE CRNR OF BLDG B) ELECTRICAL - SE CRNR OF BLDG C) WATER - E SIDE OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 12/07/2006 PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM AND FIRE EXTINGUISHER. NEAREST FIRE HYDRANT - N SIDE OF BLDG ON S SIDE OF ST ADJ TO BLDG. Building Occupancy Level 12/07/2006 80 EMPLOYEES -9- 07/12/2007 /r - ~! . ~. ~ ~ F KERN RADIOLOGY SiteID: 015-021-000821 ~ Fast Format ~ ~~~Training Overall Site ~ Employee Training 02/02/2007 ~ %~~ BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE AWARE OF LOCATION OF MATERIAL DATA SHEETS, USE OF FIRE EXTINGUISHERS, AND EVACUATION PLAN. rayc ~ MATERIAL SAFETY DATA SHEETS ON FILE. Held for Future Use Held for Future Use -10- 07/12/2007 t UNIFIED PROGRAIIA INSPECTION CHECII(LIST SECTION 1 Business .Plan and Inventory Program FACILITY NAME ADDRESS ~~ FACILITYCONTACT ~~--rte. ~ t~ L• ~1.>7V CJ Section 1: Business Plan and Inventory Program outine f7 Combined O Joint Agency ~ Multi-Agency O Complaint ~ Re-inspection C V lV=uoap nnce~ OPERATION COMMENTS ANY HAZARD`OU1S WASTE ON SITE?: YES ^ NO EXPLAIN: W ~' ~ ~'~__ • QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT 661 326-3979 -~~ _~ ~ M A--~~ te~~'t ~ nn _ _ Inspector (Please Print) Fire Prevention 1st-InlShift of Site Business Site Respo ible Pa Please Print) White -Environmental Services Yellow -Station Copy Pink - Businea5 Copy Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: 661 326-3979 INSPECTION DATE INSPE TION TIME ,/ L~o~--~ ----~v ----- Number 15-021-OIaU ~ Z l ~' T~ CITY OF BAKERSFiE1.D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES „ UNIFIED PROGRAM INSPECTION CHECKLIST `wE Aati, 1715 Chester Ave., 3`d Floor, Bakersfield, CA 93301 FACILITY NAME ~.~1~1~ ~~ld L.D~ y ADDRESS ~ 3U / T~.~4-N~~' FACILITY CONTACT Lou,~~•a~-- [NSPECTION TIME ~ ~~~/ ' ~'"~ /yam ~a w Section l: Business Plan and Inventory Program INSPECTION DATE ~~ ~3 03 PHONE NO. ~'T 32Z^l `I8 ~ BUSINESS ID NO. 15-210- $,2/ NCIMBER OF EMPLOYEES In S Routine ^ Combined ^ Joint Agency ^MuIti-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 Nazar ous w to on site?: Yes ^ No Explain: 1 ~t',/'L ~ ~~ Questions regarding this inspection? Please call us at (661) 326-3979 White -Env. Svcs. Yellow • Station Copy Pink -Business Copy Business Site esponsible Party Inspector: ~ ~~~ "-, -,, KERN RADIOLOGY Manager JOYCE AYERS Location: 2301 BAHAMAS DR City BAKERSFIELD SiteID: 015-021-000821 BusPhone: (661)-326-9600 Map 102 CommHaz High Grid: 26D FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: CAL000066021 SIC Code:8011 DunnBrad:77-025-1480 Emergency Contact / Title Emergency Contact / Title JOYCE AYERS / MANAGER JERRY STURZ / CEO Business Phone: (661) 328-6454x Business Phone: (661) 328-6455x 24-Hour Phone (661) 326-9600x 24-Hour Phone (661) 326-9600x Pager Phone (661) 342-6212x Pager Phone (661) 619-7275x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact JERRY STURZ Phone: (661) 328-6455x MailAddr: 2301 BAHAMAS DR State: CA City BAKERSFIELD Zip 93309 Owner KERN RADIOLOGY MEDICAL GROUP INC Phone: (661) 322-1981x Address 2301 BAHAMAS DR State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ENT'D F E 6 2 6 2007 -L~as~ad (~n my inquiry of those individuals responsible far obtaining thr information, 1 certify under p®naity of la+~r that I have personally examin~:d and am familiar with the information submitted and beiieve the information is true, accura and complat ,. te , ~~ ~ ~~ ~ ~/ Date ~gnature -1- 02/02/2007 !! 'j F KERN RADIOLOGY SiteID: 015-021-000821 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP DEVELOPER DH L 85.00 GAL Hi FIXER DH L 85.00 GAL Hi HELIUM F P IH G 405.00 FT3 Min WASTE FIXER R L 50.00 GAL Min -2- 02/02/2007 -3- 02/02/2007 r. , KERN RADIOLOGY i F S teID: 015-021-0 00821 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DEVELOPER Days On Site 365 Location within this Facilit Unit Ma Grid y p: : CAS# 1310-58-3 STATE TYPE PRESSURE Liquid TMixture Below Ambient TEMPERATURE Below Ambient CONTAINER TYPE PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 85.00 GAL 85.00 GAL 85.00 GAL HAZARDOUS COMPONENTS sWt. RS CAS# 89.00 Water No 7732185 3.00 Potassium Sulfite No 10117381 2.00 Hydroquinone (EPA) No 123319 3.00 Sodium Sulfite No 7757837 2.00 Potassium Hydroxide No 1310583 1.00 Potassium No rltiL~t'1CCL tiJ JL,J J1~1rJ1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Hi -4- 02/02/2007 F KERN RADIOLOGY ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME FIXER Location within this Facility Unit STATE TYPE PRESSURE _ Liquid TMixture Below Ambient SitelD: 015-021-000821 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7783-43-3 TEMPERATURE ~ CONTAINER TYPE Below Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 85.00 GAL 85.00 GAL 8.5.00 GAL t1EiGEitCLV U ~7 1:V1~lYV1V ~1V 1 J %Wt. RS CAS# 90.00 Water No 7732185 8.00 Ammonium Thiosulfate No 7783188 1.00 Sodium Sulfite No 7757837 1.00 Aluminum Sulfate No 10043013 t1E'~GKKL L-1~ 7 L J ~1~11"~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Hi ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit MRI/ISOLATED RM STATE TYPE PRESSURE _ Gas TPure Above Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7440-59-7 TEMPERATURE CONTAINER TYPE Ambient FIXED PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average - 405.00 FT3 405.00 FT3 405.00 FT3 I111GKtC11VU.~ 1.V1~lYV1VL'1V1~ ~Wt. RS CAS# 100.00 Helium No 7440597 I1HGEitCL 1-~J~1;~.71~11;1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 02/02/2007 r. F KERN RADIOLOGY ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit AT 3 TREATMENT UNITS ON SITE STATE TYPE PRESSURE Liquid TWaste ~ Ambient SiteID: 015-021-0008.21 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Cont5i00rG~ Daily M50100m GAL I Daily A30r00e GAL - rl~,~r-ax.l~uua ~ulnruiv~ly 1 %Wt. RS CAS# Silver No 7440224 riHGHKU A~~C;~51~11•/1V'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -6- 02/02/2007 F KERN RADIOLOGY SiteID: 015-021-000821 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 03/27/2006 ~ CALL 911. GENERAL ELECTRIC - 800-437-1171 - 360 W BEDFORD AVE 105 FRESNO CA 93711 CALIFORNIA IMAGING SOLUTIONS - 337-9729. OFFICE OF EMERGENCY SERVICES - 800-852-7550. Employee Notif./Evacuation 09/28/2000 PUBLIC ADDRESS SYSTEM AND FIRE ALARM SYSTEM. ALL EMPLOYEES TO EVACUATE BLDG AT EXIT NEAREST THEIR LOCATION. GATHER AT NW CORNER OF PARKING LOT FOR EMPLOYEE COUNT. Public Notif./Evacuation 09/28/2000 RECEPTIONISTS RESPONSIBLE FOR PATIENTS IN WAITING ROOM. EXPEDITORS RESPOSIBLE FOR PATIENTS IN DRESSING AREAS. TECHNOLOGISTS RESPONSIBLE FOR PATIENTS IN EXAM ROOMS. Emergency Medical Plan 03/27/2006 PHYSICIAN ON PREMISES AT ALL TIMES DURING OPEN HOURS. FULL-TIME NURSE ON STAFF. HALL AMBULANCE - 661-327-4111. LIBERTY AMBULANCE - 661-395-1111. MEMORIAL, MERCY HOSPITAL OR ER. -7- 02/02/2007 F KERN RADIOLOGY SiteID: 015-021-000821 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 09/28/2000 ~ HELIUM IS STORED IN SEPARATE ISOLATED ROOM. WASTE IS STORED IN RED AIR TIGHT HAZARDOUS CONTAINERS. PROCESSING CHEMICALS IN PLASTIC CONTAINERS. SPRINKLER SYSTEM THROUGHOUT BLDG. SAFETY TRAINING MANUAL FOR EMPLOYEES. Release Containment 03/27/2006 HAVE 50 LBS OF KITTY LITTER ON PREMISES AT ALL TIME. HAVE PERMANENT HAZARDOUS WASTE CONTAINMENT AND CLEAN-UP KIT. Clean Up 09/28/2000 SPREAD KITTY LITTER, USE SQUEEGEE AND DUST PAN. INSERT IN HAZARDOUS WASTE CONTAINER. HAVE CONTRACT WITH HAZARDOUS WASTE DISPOSAL COMPANY, (BFI MEDICAL WASTE SYSTEMS) TO REMOVE HAZARDOUS WASTE. Other Resource Activation -8- 02/02/2007 :~ . F KERN RADIOLOGY SiteID: 015-021-000821 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards 03/27/2006 ~ RADIOISATOPES ON HAND - RADIATION HAZARD. CONTAINERS ARE USED FOR ALL RADIOISOTOPES AND HAULED OFF-SITE BY BFI MEDICAL WASTE SYSTEM AND CARDINAL HEALTH. Utility Shut-Offs 03/27/2006 A) GAS - SE CRNR OF BLDG B) ELECTRICAL - SE CRNR OF BLDG C) WATER - E SIDE OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM AND FIRE EXTINGUISHER. NEAREST FIRE HYDRANT - N SIDE OF BLDG ON S SIDE OF ST ADJ TO BLDG. 12/07/2006 Building Occupancy Level 12/07/2006 80 EMPLOYEES -9- 02/02/2007 -. k F KERN RADIOLOGY SiteID: 015-021-000821 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/02/2007 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE AWARE OF LOCATION OF MATERIAL DATA SHEETS, USE OF FIRE EXTINGUISHERS, AND EVACUATION PLAN. rayc ~ Held for Future Use azciu ivi rut,uic vac -10- 02/02/2007 :: + KERN RADIOLOGY ________________________ ______________ SiteID: 015-021-000821 + ~c~~c~ dyers Manager DEBa~~ "'L-~ "~~~~ BusPhone: (661) 322-1981~~~(v-~~6 Location: 2301 BAHAMAS DR Map 102 CommHaz High City BAKERSFIELD Grid: 26D FaCUnits: 1 AOV: CommCode: BFD STA Ol SIC Code:8011 EPA Numb: CAL000066021 DunnBrad:77-025-1480 ~1 Emergency Contactt, C~/ T'itle / Emergency Contact / Title ~,~0 ~ ,s/ MANAGER ~$-~o7S~j / ~tlT'T+rmT/1TTC~ nnrR L1~J1 ~~ ~t Business Phone: 661) ~ 0~ 2l '~l 1 Business Phone: (661) ~~x~.~fj'~y ~ 0 -~.~-,-,-_3 24-Hour Phone (661) '"""' 24-Hour Phone (661) ~"~9~~x3'~~~~` v Pager Phone ( 661) ~~ ^'x ~ Pager Phone ( 661) ^ "~"""' __-~~4'`7~ 75 Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact L - ci e v' i^y S'Itit r z Phone : ( 6 61) it " - ' ~ MailAddr: ~^ °^° ^'°8 ~30~ a3aharnus br' State: CA City BAKERSFIELD Zip 93309 Owner KERN RADIOLOGY MEDICAL GROUP INC Phone: (661) 322-1981x Address 2301 BAHAMAS DR' State: CA City BAKERSFIELD Zip 93309 Period to Preparers Certif'd: ParcelNo: TotalASTs: _ TotalUSTs: _ RSs: No Gal Gal Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN 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 and believe the information is true, accurate, and co lete. Sig uanSig e ~ Date ENT ~~~ ~ ~, . coos -1- 02/28/2006 Hazardous Materials/Hazardous Waste Unified Permit ~ CONDITIONS OF Pl=RMIT ON Fll::¥1=R$1= $1Dl= This ~ermit is issued for the followin_.: I~ Hazardous Materials Plan [] Underground Storage of Hazardous Materials Permit ID #:: 015-000-000821 [] Risk Management Program KERN RADIOLOGY M E DICAL [] Hazardous Waste On-Site Treatment LOCATION: 2301 BAHAMAS DR ~..., .~- i~ .. . ~, OFFICE OF EN~R ONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Approved by: . ~lp~Hu~,6~~ Issue ~te Bakersfield, CA 93301 O~ceofEv~S~ic~ Voice (661) 326-3979 F~ (661) 326-0576 ExpimtionDate: Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ...... ?~,~?~?~?~mm ...... This permit is issued for the following: ~~PE~T ~ ~ 015-021-000821 ~IOLOGY LOCATION 2301 ~L" '"...~ Issu~ by: B~ersfield Fke Depa~ment Approved by: ' 1715 Chewer Ave., 3rd Floor t B~e~fiel~ CA 93301 Voice (805) 32~3979 F~ (80S326-0576 Expiration Date: dun~ $O~ ~O00 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ......... ~,,¢?~'?'?;~!?'77~?!'?i~!,~,,~,,~,,, ........ This permit is issued for the following: LOCATION 2301 ~C"-~. % '~¢~= ' ........ "~:'" ....-'" ]ssu~ by: OFFICE OF EN~R O~AL S~ ~CES 1715 Chewer Ave., 3rd Floor /~ ~Pho~ce HUeYof ~enml~S~i~ B~e~fiel~ CA 93301 Voice (805) 326-3979 F~ (805)3~6~576 Exp~ationDate: ~n~ 30~ ~000 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r~ Floor, Bakersfield, CA 93301 ADDRESS ~_..go I ~,,q~~ FACILITY CONTACT ~ ~~ BUSINESS ID NO. 15-210- ~/ ~SPECTION TIME~ '~ mt~ ' NUMBER OF EMPLOYEES Section 1: Business Plan and lnvento~ Program Routine ~ Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate pe~it on hand Business plan contact info~ation accurate Visible address Co~ect occupancy Verification of invento~ 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 Quesfiom r~8~din~ ~i~ ~efion? ~1~ ,~11 u~ ~t {661) ~26-~9~9 ~sponsible Pa~y :~KERN RADIOLOGY MEDICAL OUP INC SiteID: 015-021-000821 Manager :.~-5~W~A~'C~ r~~ BusPhone: (661) 322-1981 Location: 2301 BAHAMAS DR Map : 102 CommHaz : Moderate City : BAKERSFIELD ,~%1~%~ Grid: 26D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:8011 EPA Numb: CAL000066021 DunnBrad:77-025-1480 Emergency Contact / Title Emergency Contact / Title - ~v~ ~,,~ / MANAGER LOIS ELDRIDGE-LEE / OPERATIONS MGR Business Phone: (661) 852~441x~ Business Phone: (661) 852-2440x 24-Hour Phone : (661) 324-2723x 24-Hour Phone : (661) 587-5799x ~ .... ~-~ ~ .... ~ (66~) 0 Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact : LOIS ELDRIDGE-LEE Phone: (661) 852-2440x MailAddr: PO BOX 2388 State: CA City : BAKERSFIELD Zip : 93309 Owner KERN RADIOLOGY MEDICAL GROUP INC. Phone: (661) 322-1981x Address: PO BOX 2301 BAHAMAS DR State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: I,~,..~,/'~' ~ /"~,._,__d='~ Do hereby certify that I have ~ype o~ I)~nt name) reviewed the attached;,/.~hazard°us materials manage. ment plan foF/~J'n ~O/~ that it along with (Name of any corrections constitute a complete and correct man- agement plan for my facility. 1 08/22/2003 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~"C~'z~ ~dXOto'c~c~ INSPECTION DATE '7 Section 4: Hazardous Waste Generator Program EPA ID # (~_~L. E2DO O~O~-. D Routine ~.~ Combined D Joint Agency D Multi-Agency D Compl~nt Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made ~t/-~..o._ ~E~rC_.a, tLa~ '~'L~.~q't,n~,., r-- EPA ID Number (Phone: 916-324-17~ 1 to obtain EPA ID #) Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence or maintains a contingency plan and training Established Hazardous waste accumulation time frames ( Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kepi 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 fi.om land disposal C=Compliance V=Violation Inspector: ~) 1 ~5 Office of Environmentai Services (661) 326-3979 Business Site Responsible Party ~ White - Env. Svcs. Pink - Business Copy Kern Radiology Medical Group, Inc. 2301-Bahamas Drive Bakersfield, CA 93309 (661) 322-1981 April 3, 2,00t Mr. Howard Wines III Bakersfield .Fire Department 3rd Floor 1715 Chester Avenue Bakersfield, CA 93301 Dear ~Mr.-Wines, Enclosed are the items we discussed on the phone today. I hope that this is all the information required of Kern Radiology Medical Group, Inc. if I inadvertently left something out please do not hesitate to contact me at (661) 852-2440. The folio ~wjngi .roms are: · Letter from the Department of Health Services · Emergency Procedure for Radioactive Spills · Procedure for Onsite Decay'Storage · N~jclearMedicine Equipment andDepar{ment Description · Labeled Diagram of Department · Evacuation Plan ( Same as Fire) Thaqk you-for .your assistance. Lois Eldridge-Le'e~ ~ Operations-Manager STATE OF CALIFORNIA--HEALTH AND HUMAWRVICES AGENCY GRAY DAVIS. Governor DEPARTMENT OF HEALTH SERVICES ~ RADIOLOGIC HEALTH BRANCH P,O. BOX 942732, MS-178 SACRAMENTO. CA 94234-7320 (916) 445-0931 February 161 '2001' RADIATION SAFETY ADVISORY 01-1 TO: All Radioactive Materials Licensees SUBJECT: Required Notification by Licensees of Pr~esence of Radioactive Materials Wildfires that occurred last year around several national laboratories in the western states prompted concern over possible release of airborne radioactive material from the burning of vegetation in radioactively contaminated areas. It was determined throUgh extensive airborne sampling that the predominant radioactive constituents of these wildfires were naturally occurring daughters of radon, and that the dose consequences to firefighters and the public were not significant. Nevertheless, the occurrence of these wildfires has prompted the Department of Health Services, Radiologic Health Branch (RHB) to take this opportunity to remind all radioactive materials licensees of their obligations concerning notification to local fire departments. Health and Safety Code sections 25503, 25503.5, 25504, 25505, 25507 and 25509 require each handler of hazardous material (including radioactive material), to submit an emergency response plan to the local fire department(s) and other appropriate local emergency respOnse personnel. The plan must include, but is not limited to, all of the following: Immediate notification to the appropriate local emergency rescue personnel, · Procedures.for..the.mitigation of~arelease.~or, threater~edreleasetominimize any potential harm or damage to persons~ property;.or, the environment, and · Evacuation plans and procedures, including immediate notice, for the business site. In addition, Code of Federal Regulations, title 10, part 20.2202 as incorporated in California by California Code of Regulations, title 17, section 30253 requires radioactive material licensees to report to RHB any event involving the release or threatened release of radioactive material that exceed the limits specified in this regulation. Therefore, radioactive material licensees are respOnsible for necessary notifications to the local emergency response agencies and RHB in the event of a release or threatened release of radioactive material. All Radioactive Materials Licensees February 16, 2001 Page 2 It is hoped that this advisory will facilitate the required precautions and therefore mitigate the possibility of any release of radioactive material. Implementation of this advisory requires no response to RHB, but you are encouraged to contact your local fire department or other emergency response agencies for assistance in meeting your obligations to them. If you are unsure of the appropriate authority to contact, please notify your local city or county government. ~-~'~g~-r,,~. Bailey, ~:-I. P., Chief / Date Radiet'ogic Heak~h Branch ~. (Table 2) EMERGENCY PROCEDURES FOR RADIOACTIVE SPILLS EMERGENCY NUMBERS: Radiation Safety Officer David P. Schale, M.D. 872-6525 Alternate RSO Nitin S. Athavale, M.D. 665-9462 Or on call physician (available 24 hours/day) 322-1981 Technologists Lynn Duncan 861 ~ 1375 Hazardous Materials Bureau I. Minor Spills ~ 0.1 mCi Iodine, 1.0 mCi other radionuclides) 1. Notify persons in the immediate area(s) that a spill has occurred. 2. Cover the spill with absorbent paper. 3. Limit access to the area only to those persons dealing with the spill. 4. Survey (G.M. survey meter) potentially contaminated personnel before they leave the area. 5. Decontaminate as necessary. 6. Notify the Radiation Safety Officer of the incident. II. Major Spills ~ 0.1mCi Iodine, 1.0 mci other radionuclides) 1. Notify all persons not involved in the spill to vacate the room at once. 2. Cover the spill with absorbent paper. 3. Switch off all fans. Close windows. 4. Vacate Room. 5. Close the door to the room. Prevent entry into the room. 6. If the spill is on the skin, flush thoroughly. 7. If the spill is on clothing, discard outer or protective clothing at once, to appropriate shielding storage container. 8. Notify the Radiation Safety Officer immediately. 9. Survey (G.M. survey meter) personnel involved. Immediately initiate decontaminent of personnel as necessary, using soap or special chelating soap and water. Accreditation/NucMed/Emergency spil199/db Kern Radiology Medical Group, inc. 2301 Bahamas Ddve -Bakersfietd,-CA93309 (661) 322-1981 Policy: Onsite Decay Storage Nuclea~ Medicine.Department Purpqse: -Toen~§ure-the'safety'of"the~alpopulation and the-employees of Kern RadiOlogy Medical Group, Inc. that no waste is disposed of in the "normal" trash that is collected daily. Process: 1. Rajdioactive-wastenotretumed~to~themanufactureis immediately segregated-into two categories: Very Short and Short- lived Radioisotopes i.e. (Tc-99m waste products) (and a combination of Thallium-201, Indium-Ill, and Gallium-67) respectively. To prevent mixing of isotopes, separate sharps containers are utilized. One container is labeled "Tc99m Waste" while the other container is.a .combination of 201-TI, 67,Ga, and In-111 and is labeled "Other Waste". Any remaining labels are removedorobliterated-as the containers .are being filled. 2. The sharps containers are stored in a 3'x3'x3' Iockable, key-type, lead-lined decay cabinet. The decay cabinet is locked after hours and when the technologists are out of the department. Access to the decay cabinet key is limited to the nuclear medicine technologist staff and.the radiation safety officer. 3. When a sharps container is full, it is sealed with its provided tight-fitting lid and is d~atedwiththe-starting decay pefioddate. Acalcutafion is.madefora-minimumof't0 half-lives and the date is recorded on the sharps container also. The container will remain in storage for decay in the decay cabinet for no less than 10 half-lives. An entry is made on our RadioactiveWaste Disposal Record ',log sheet". (exhibit 1) 4. Radioactive waste inventory control is accomplished by entdes on the Radioactive Waste'Disposal ~Record. A complete en{ry-includesdate sealed,-department background radiation level, and the initial of the recording technologist. Disposal information is also noted after a minimum of 10 half-lives of decay. A complete entry for disposal includes minimum 10 half-life date, background radiation level, ending container radiation .level and the initial of.the.recording technologist. A comment is made as tothe date that the container is released to our commercial waste service (BFI.Medical Waste) and an additional survey-is performed.to ensure radioactivity cannot be distinguished from background. 5. The decay cabinet is surveyed each working day when performing the daily department survey. A Ludlum model 3, sedal number 123461, Gm tube 127068 is used to perform the daily .surveys. Wipes are performed weekly on the lead-lined storage cabinet. Medical Spectrometer, Atomic Products model 187-295, serial number900t-0509in conjunction.with Well-Counter, style 2804F, serial-number 1141 is used to count wipes. The decay cabinet is open while the sharps containers are being surveyed. 6. No Iodine 1-131 is retained for on-site decay at Kern Radiology Medical Group, Inc. All Iodine 1-131 materials not used are sent back to the manufacturer for decay and disposal as per the Departmentof Transportation requirements. Nucl~earMedicine On-Site Decay Storage Process 4101 Radioactive Waste Disposal Record T 1/2 Nuclear Medicine Department Ga - 67 78.1 hrs TI - 201 73 hrs This record is for (check one) In - 111 67.2 hrs Tc - 99m 6.03 hrs Very Short-lived materials Tc-99m Short-lived materials TI-201, In-ll 1, Ga-67 Sealed Container Disposal Information Background Container Background Container Date (mR/hr) (mR/hr) Initial Date (mR/hr) (mR/hr) Initial Comment The Nuclear Medicine Department at Kern Radiology Medical Group, Inc. consistsof,the following: 1. Imaging room designated (Camera Room 1). This area houses a Seimens ECAM Dual Head System. 2. Imaging room designated (Camera Room 2). This area houses a Seimens ECAMDuatHead System. 3. An area designated (Work Station) where patients are greeted and prepared for their examinations. 4. An area designated as the (Office) is where examinations can be remotely pr~ocessed and reviewed ~bythe technologists and-the radiologist. 5. The (Hot Lab) houses a lead-brick-lined cave area with a built,in fume hood vented directly to outside air. There is a leaded glass window shield that extends from the upper front and side margins of the lead brick cave lining to the Iowerm¢. tat-skirt-of-the-fume hood. -Various leaded shields, storage containers and remote handling equipment are located behind the cave area. All radioactive individual unit pharmaceutical doses, spot markers and vial sources for quality control work are kept in the cave area. In addition to this, some ,ofthe--daily-generated-.radioactive waste materials are kept.-in-.the..cave area. Radioactive materials are prepared behind the cave area and regular receipt of radio)active ~materiats are-delivered-in the-Hot Lab and placed at.thefoot-of the cave area on the floor as the designated area for all radioactive materials deliveries. There is a special sectioned leaded ring cylinder 14" high and 8" diameter with recessed.tight fitted teaded cap radioactive waste material-vessel located on the counter top in the Hot Lab. This vessel is also used to collect and store daily radioactive waste. 6. (Central Waste Storage). This is a special designed 3'x3'x3' lead sheeting lined,-Jockable cabinet where-heavy plastic radioactive-sharps containers can be stored and decayed for subsequent disposal. Note: .A separate keyed and labeled diagram showing the location of shielding proximity-of.radiation to--unrestricted areas, etc.--is attached. Nuc. Med. Department Description 4/01- IProcedure Type: Fire Date: Emergency/E~vacujtffpPn /ff._ // Proce~lure: FireEmergency/FireDritt/EvacuationProcedures and Responsibilities Purpose: To ensure the safety of the general population and the employees of Kern Radiology Medical Group, Inc., to limit harm and maintain a safe environment when an occu~eaee-~ates-that-the facility-be evacuated-that it-is orderly andexpeditious. Process~ Discovery-discoverer must determine whether to extinguish or to dose off area and call the operator. Whom to notify first: decisions are to be made on the situation and the severity of the fire. If coworkers are present-call out for help and give specific details, location and type of fir~e. }tow. to notify: say "wastebasket fire in mammo room" or" electrical fire in file room." This will give the operator the correct terminology to use when calling 911. Public address announcement wording: "Code red in mammography room". When the situation has meleared or it has beendeemedsafe-m return to building annotmce, '-'Code Red clear"i Responsibilities:. use team approach, call those in the immediately are by NAME, one person caltsthe-operator,-one gets-the fire~xtinguisher or starts patient evacuation. Operators/Schedulers: announce over PA, "Code red in mammography room" Operator and schedulers should use the team approach and verbally designate duties to each other. Shut down terminals. Additionally, you will assist in evacuating patients. Close all doors in your-respective area after checking foroecupants. Nurse/Technologist: Evacuate your areas of patients, visitors, and assist others. Turn off 02 canisters and machine consoles; shut down terminals, close doors after checking x-ray rooms, dressing andrestrooms for occupants. O2 must be mined off in: Stress Room Nurse's Station CT/MRI 'Special..P.rocedures Policy mad Proceduros Fire Eme~gmcy/Evacuation 4/01 Page 1 of 2 Doctors: Assist in evacuation Of immediate area, assist in patient handling and assessment, and shut down all terminals and view boxes. Clerks: Second floor, shut down all terminals, close doors after checking kitchen, restrogms, offices, etc. Assist .patients and visitors. Clerks: First floor, assist in immediate areas and with front lobby evacuation, cheek restrooms, close doors, and shut down all terminals. Transcription: shut down machines, all terminals, printers, etc. Assist patients, visitors, and eoworkers in immediate area. Expediters: Assist in patient, visitor evacuation, cheek dressing areas', close doors. Wheelchairs may be needed from hallway by MRI/CT. File Room Personnel: Cheek with and help in the immediate area, assist in nurse's station;close area-doors. Escape routes, outside meeting area: meet at WEST END OF PROPERTY NEAR DUMPSTERS. Use safest, Nearest exit. General Guidelines: · Learn toeations -of nearest fire-extinguishers · Do not use elevator. · Do not stop to take valuables. · Stay~ealm,-do.not rush. Before and after hours: Call front desk to report type and location of fire. Front desk personnel can then alert others and call 911. Personnel whodo-not have patients-in their areas must respond by ~going ~to .aid ~hose-in fire area with fire extinguishers. Policy and Procedures Fire En3~rgen¢~YEvaeuation 4/01 ' Page 2 of 2 KERN RADIOLOGY MEDICAL GROUP INC SiteID: 015-021-000821 Manager : LC)~d ~~i"r-t'3 ~EC~) BusPhone: (805) 322-1981 Map ': 102 CommHaz :' Moderate Location: 2301 BAHAMAS DR ~P ,~, 6 ~ Grid: 26D FacUnits: City : BAKERSFIELD 1 AOV: CommCode: BAKERSFIELD STATION 01 ". S~I/~- SIC Code: 8011 EPA Nu~: C~000066021 "~c~' DunnBrad:77-025-1480 Emergency ~ontadc / Title .~ - ~mergency / Business Phon~'~ 322-1981x~-~q~% Business Phone~i(SO5) 322 24-,our Phone ~/<~ ~~9~%~3 24 .our ~none ~er ~no~e : (~ ) ~q-~ ~ / ~a~er ~none Hazmat Hazards: Fire Press React Im~lth DelHlth con~ac~ : LO;~ ~/~,~--~ ~h°ne: MailAddr: PO BOX 2388 State: CA City : BAKERSFIELD Zip : 93309 O~er KE~ ~lu~OGz & i,~CLE~ i.iED C~'- Phone: (805) 322-1981x Address : ~DC ~OX 23~ Z~O~ ~~m~ ~. State: CA City :'BAKERSFIELD Zip : 93309 Period :' to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif 'd: RSs: No Emergency Directives: THIS IS A WASTE TREATMENT 'sITE ~ REQUIRES A JOINT INSPECTION. PLEASE C~L E~ SVCS TO SCHEDULE THIS INSPECTION WITH HOW~D WINES._ = Hazmat Inventory One Unified List -- As Designated Order All Materials at Site azma Common DEVELOPER DH L 85.00 G~ Hi FIXER DH L 85.00 G~ Hi HELI~ F P IH G 405.00 FT3 Min WASTE FIXER R L 50.00 G~ Min I, ~ ~Mr;~-~ Do hereby ce~ily that I have "'¢y~ or reviewed the a~ached h~ardous materials manage- for E~¢ ~a,o ment plan H¢m~ ~uo~and that it along with (Na~ Of any corre~ions ~nStitute a complete and corre~ man- agement plan for my facili~. ~g~mre ~ ? ? KERN RADIOLOGY MEDICAL GROUP INC SiteID: 015-021-000821 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site DEVELOPER Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 1310-58-3 Liquid /Mixture Below Ambient Below Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest .Container , Daily Maximum I Daily Average GAL 85.00 GALI 85.00 GAL ~'"J.~.Z-~UU~ ~U~U~'~ %Wt. RS CAS# 5.00 Potassium Hydroxide No 1310583 5.00 Diethylene Glycol No 111466 5.00 Hydroquinone (EPA) No 123319 1.00 1-Phenyl-3-pyrazolidinone No 92433 1.00 Glutaraldehyde No 110308 15.00 Acetic Acid, Anhydride No 108247 HAZARD ASSESSMENTS lTSecretl ~S BiOHaz RadiOactiVe/AmountNO N No No/ Curies EPA HazardSDH NFPA/// I USDOT# IMCpHi 2 08/29/2000 KERN RADIOLOGY MEDICAL GROUP INC SiteID: 015-021-000821 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~U/V~Vl~ ~vl~ / ~ ~ ~,Z'"~.L~ ~Vl~ FIXER Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 7783-43-3 Liquid /Mixture Below Ambient Below Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average GAL 85.00 GAL 85.00 GAL %Wt. RS CAS~ 15.00 Ammonium Thiosulfate No 7783188 1.00 Sodium Sulfite No 7757837 1.00 Acetic Acid, Anhydride No 108247 1.00 Aluminum Sulfate No 10043013 1.00 Sulfuric Acid (EPA) No 7664939 HAZARD ASSESSMENTS TSecretl~sIBi°Haz'Radi°active/Am°untNo N No No/ Curies EPAHazardsDH NFPA/// IUsDOT# HiMCP ~ Inventory'Item 0003 Facility Unit: Fixed Containers on Site ~ ~Ulv~vlu~ ~vl~ / ~£ ~ ~vl~ HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: MRI/ISOLATED ROOM CAS# 7440-59-7 Gas PUre Above Ambient Ambient FIXED PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average FT3 405.00 FT3 405.00 FT3 100.00 Helium N 7440597 HAZARD ASSESSMENTS TSecret RS SioHaz Radioactive/Amount EPA Hazards I NFPA I USDOT# MCP No No No No/ Curies F P IH / / / Min 3 08/29/2000 KERN RADIOLOGY MEDICAL GROUP INC SiteID: 015-021-000821 ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site WASTE FIXER Days On Site WASTE PHOTO FIXER SOLUTION 365 Location within this Facility Unit Map: Grid: AT 3 TREATMENT UNITS ON SITE CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid /Waste~ } Ambient I Ambient I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest ~ontainer I Daily Maximum I Daily Average 5.00 GALI 50.00 GAL I 30.00 GAL HAZARDOUS COMPONENTS %Wt. RNo~ CAS# Silver 7440224 HAZARD ASSESSMENTS TSecretI ~SIBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# I MCP No N No No/ Curies R / / / Min -4- 08/29/2000 'F KERN RADIOLOGY MEDICAL GROUP INC SiteID: 015-021-000821 Fast Format = Notif./Evacuation/Medical Overall Site --Agency Notification 07/31/1997 CALL 911 GENERAL ELECTRIC - 397-6144 CALIFORNIA IMAGING SOLUTIONS - 3101 16TH ST #110 - 337-9729 OFFICE OF EMERGENCY SERVICES - 800-852-7550 -- Employee Notif./Evacuation 03/11/1991 PUBLIC ADDRESS SYSTEM FIRE ALARM SYSTEM ALL EMPLOYEES TO EVACUATE BUILDING AT EXIT NEAREST THEIR LOCATION. GATHER ATNORTHWEST CORNER OF PARKING LOT FOR EMPLOYEE COUNT. -- Public Notif./Evacuation 07/13/1998 RECEPTIONISTS RESPONSIBLE FOR PATIENTS IN WAITING ROOM. EXPEDITORS RESPO~IBLE FOR PATIENTS IN DRESSING AREAS. TECHNOLOGISTS RESPONSIBLE FOR PATI'ENTS IN EXAM ROOMS. Emergency Medical Plan 07/13/1998 PHYSICIAN ON PREMISES AT ALL TIMES DURING OPEN HOURS. FULL-TIME NURSE ON STAFF HALL AMBULANCE - 805-327-4111 GOLDEN EMPIRE - 805-327-9000 MEMORIAL, MERCY HOSPITAL OR ER 5 08/29/2000 KERN RADIOLOGY MEDICAL GROUP INC SiteID: 015-021-000821 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 07/13/1998 HELIUM IS STORED IN SEPARATE ISOLATED ROOM. WASTE IS STORED IN RED AIR-TIGHT HAZARDOUS CONTAINERS. PROCESSING CHEMICALS IN PLASTIC CONTAINERS. SPRINKLER SYSTEM THROUGHOUT BUILDING. SAFETY TRAINING MANUAL FOR EMPLOYEES. -- Release Containment 09/09/1992 HAVE 50 LBS OF KITTY LITTER ON PREMISES AT ALL TIME. HAVE PERMANENT HAZARDOUS WASTE CONTAINMENT AND CLEAN UP KIT. -- Clean Up 07/31/1997 SPREAD KITTY LITTER, USE SQUEEGEE AND DUST PAN. INSERT IN HAZARDOUS WASTE CONTAINER. HAVE CONTRACT WITH HAZARDOUS WASTE DISPOSAL COMPANY, (BFI MEDICAL WASTE SYSTEMS) TO REMOVE HAZARDOUS WASTE. Other Resource Activation 6 08/29/2000 KERN RADIOLOGY MEDICAL GROUP INC SiteID: 015-021-000821 Fast Format ~ Site Emergency Factors Overall Site -- Special Hazards 07/31/1997 RADIOISATOPES ON HAND - RADIATION HAZARD CONTAINERS ARE USED FOR ALL RADIOISOTOPES AND HAULED OFF SITE BY BFI MEDICAL WASTE SYSTEM. -- Utility Shut-Offs 07/13/1998 A) GAS - SE CORNER OF BLDG B) ELECTRICAL - SE CORNER OF BLDG C) WATER - E SIDE OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 07/13/1998 PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM AND FIRE EXTINGUISHER. NEAREST FIRE HYDRANT - N SIDE OF BLDG ON S SIDE OF ST ADJACENT TO BLDG. Building Occupancy Level 7 08/29/2000 KERN RADIOLOGY MEDICAL GROUP INC SiteID: 015-021-000821 Fast Format ~ Training Overall Site -- Employee Training 07/13/1998 EMPL YE AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE AWARE OF - 1) LOCATION OF MATERIAL DATA SHEETS 2) USE OF FIRE EXTINGUISHERS 3) EVACUATION PLAN- ~e I~f~ ~ ~O iPage 2 --Held for Future Use --Held for Future Use 8 08/29/2000 ~---~KERN ~RA~DIOLOG~YJ_MEDICAL-GRO:U~P-~-INC. , ~-~~ 2301 Bahamas Drive Bakersfield, CA 93309 (805) 322-1981 June 9, 1998 !B~y~~~ B~ersfield Fke Depmment Mtn: Ralph Huey 1715 Chester Ave. pp ~q ~ B~ersfield, CA 93301 ~ De~ ~. Huey, Please see the copy of the enclosed Pemit to ~erate for Kern Radiolo~ Me&cal Group, he. please note that the nme on the pemit is inco~ect. Please ch~ge ~d resend us a co~ected pe~it. Kern Radiolo~ Medical Group, Inc. would l~e to ~so request 25 additional stickers for h~dous material spill repoaing. If you have ~y questions please cfll me at (805) 322-1981 ext. 236. Th~ you~ ~~ Mailing Address: P.O. Box 2388- Bakersfield, CA 93303- Fax No: (805) 324-1298 CITY OF BAKERS~LD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 ~-' / HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per matedal per building or area) .. O ELETE !0o Pago __ o' __ CHEMICAL LOCATION A ~ ~ T~~ ~ ~ ~ , ~% ~ ~ I ~ 201~NFIDENTIALCHEMICAL LOCATION(EPC~) E V~ ~ No 202 - ~1 ~1 ~P,(opt~naO 2031GRlD,(opt~na0 204 205 T~DE SECRET ~ Yes ~ No 206 CHEMICAL NAME ~'~ ~ ~ F/ XC'~ ~O~ If Subj~ to EPC~, refer to iinst~ions 207 COMMON NAME EHS* ~ Y~ ~ No 208 F~RE CODE H~RD C~SSES (Complem if r~u~t~ by I~1 fire 210 ~PE ~ p PURE ~ m M~URE ~ w WASTE 2~ ~D~OACT~VE ~ Y~ ~No 212 CUR~ES 2~ FED H~RD CATEGORIES ~ I FIRE ~ REACTIVE ~ 3 PRESSURE RE~SE ~ 4 ACUTE H~LTH ~ 5 CHRONIC H~LTH 216 (~ all that apply) AMOUNT DAILY AMOUNT DAILY AMOUNT UNITS* ~ ga GAL ~ d CU ~ ~ lb LBS ~ tn TONS 221 DAYS ON SITE 222 * If EHS, amount must be in lbs, STOOGE CONTAINER (Check all ~at apply) ~ a ABOVEGROUND TANK ~ e P~STIONONMETALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL CAR 223 ~ b UNDERGROUND TANK ~ f CAN ~ j BAG ~ n P~STIC BO~LE ~ r OTHER ~ c TANK INSIDE BUILDING ~ g CARBOY ~ k BOX ~ o TOTE BIN ~ d STEEL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WAGON STOOGE PRESSURE ~ a AMBIENT ~ aa ABOVE AMBIE~ ~ ba BELOW AMBIENT 224 STO~GETEMPE~TURE ~ a AMBIE~ ~ aa ABOVE AMBIENT ~ ba BELOW AMBIENT ~ c CRYOGENIC 225 1 O.~ 226 ~r~ ~ 227 ~Y~ ~No 228 ' . 229 2 230 231 ~ Y~ ~ NO 232 . 233 3 234 235 ~ Y~ ~ No 236 . 237 4 ] 238 239 ~ Y~ ~ NO 240 241 DES FORM 2731 (7/98) P:\OES2731 .TV4.wpd ,{KERN~RADIOLOGY MEDICAL GROUP I~-,.**'-~L~%~L-'"---~ SitelD: 215-000-000821 Man~ger : I JUL 1 3 1998 B~sPhone: (805) 322-1981 ' Location: 2301 BAHAMAS DR t // M~p : 102 CommHaz : Minimal City : BAKERSFIELD ~y,. G~id: 26D FacUnits: 1 AOV: CommCode:' BAKERSFIELD STATION 01 SIC Code:8011 EPA Numb: CAL000066021 DunnBrad:77-025-1480 Emergency Contact / Title Emergency Contact / Title DONALD FITZGERALD / MD PRESIDENT LYNN REID BRENNAN / BUSINESS MGR Business Phone: (805) 322-1981x Business Phone: (805) 322-.1981x210 24-Hour Phone : (805) 871-0664x 24-Hour Phone : (805) 398-3225x Pager Phone : ( ) - x .Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: ( ) - x MailAddr: PO BOX 2388 .. State: CA City : BAKERSFIELD Zip : 93309 Owner KERN RADIOLOGY ~-~ Phone: (805) 322-1981x Address : PO BOX 2388 ~~ ~0~Q~-~%~. ~State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: THIS IS A WASTE TREATMENT SITE AND REQUIRES A JOINT INSPECTION. PLEASE CALL ENV SVCS TO SCHEDULE THIS INSPECTION WITH HOWARD WINES. -- Hazmat Inventory One Unified List -- As Designated Order Ail Materials at Site Hazmat Common Name... ISpeoHazlEPA HazardsI Frm DailyMax UnitlMCP DH L 85 GAL Hi DEVELOP~,R_Lunn ~o'd-i'2~r~o hereby certify that I hav~ DH L 8S GAL Hi FIXER ' ~~ . F P IH G 405 FT3 Min HELIUH reviewed ~he a..1.1ached,.,ha.z, ardou$ materials mana§~o ment plan for~3 ~r~,.TnC, and that i~ aloha v~h any corrections constitute a complete and correct man- agement plan for my facility. i~ERN~RADIOLOGY MEDICAL GROUP INC ~~~~ SiteID: 215-000-000821 i~'Inventory Item 0001 ~~~ Facility Unit: Fixed Containers on Site i~ COMMON NAME / CHEMICAL NAME ~~~~~~~~~~i DEVELOPER o Days On Site o o 365 o Location within this Facility Unit Map: Grid: o CAS# o o 1310-58-3 o i~ STATE ~ TYPE ~~ PRESSURE ~ TEMPERATURE ~£~ CONTAINER TYPE Liquid o Mixture o Below Ambient o Below Ambient o PLASTIC CONTAINER. o i~~~~~~i AMOUNTS AT THIS LOCATION , Largest Container o Daily Maximum o Daily Average o GAL o 85.00 GAL o 85.00 GAL o Maximum Stored o Maximum Open Use o Maximum Closed Use o GAL o GAL o GAL o ~eeeeeee~eeeeeeeeeeeeee HAZARDOUS COMPONENTS eeeeeeeeeeeeee~eee~eeeeeeeeeeeeeeei %Wt. o o RSo CAS# o 5.00opotassium Hydroxide ONo o 1310583° 5.00ODiethylene Glycol ONo o 111466° 5.00OHydroquinone (EPA) °Yes° 123319° 1.00ol_Phenyl_3_pyrazolidinone ONo o 92433° 1.00OGlutaraldehyde ONo o 110308° 15.00OAcetic Acid, Anhydride ONo o 108247° 2 06/16/1998 KERN RADIOLOGY MEDICAL GROUP INC ~~~~ SiteID: 215-000-000821 Inventory Item 0002 ~~~ Facility Unit: Fixed Containers on Site i~ COMMON NAME / CHEMICAL NAME FIXER o Days On Site o 365 Location within this Facility Unit Map: Grid: o CAS# o 7783-43-3 ae~eee~eee~ee~ee~e~~~eeeeeee~eee~~ee~eeeeee~ee~e~ee~~~eeee~ee~ueee~~~e~~ee~ee~ef i& STATE &i~ TYPE &&&£&& PRESSURE ~&&~ TEMPERATURE &&~&~&& CONTAINER TYPE Liquid o Mixture o Below Ambient o Below Ambient o PLASTIC CONTAINER i~&~&~&&~&&&&6~&&&&&&&&&[ AMOUNTS AT THIS LOCATION Largest Container o Daily Maximum o Daily Average GAL o 85.00 GAL o 85.00 GAL Maximum Stored o Maximum Open Use o Maximum Closed Use GAL o GAL o GAL ~ee~e~ee~eeee~eeee~e~eeueeee~ee~eeeee~eeeeeeeeegeueeee~eee~e~eeeeeeeeeeeeeef i&&&&&~&~&&&&&&&~&&&&&& HAZARDOUS COMPONENTS %Wt. o o RSo CAS# 15.00°Ammonium Thiosulfate ONo o 7783188 1.00°Sodium Sulfite ONo o 7757837 1.00°Acetic Acid, Anhydride ONo o 108247 1.00°Aluminum Sulfate ONo o 10043013 1.00°Sulfuric Acid (EPA) °Yes° 7664939 -3- 06/16/1998 KERN RADIOLOGY MEDICAL GROUP INC &&~&A&&&&&&&~&&&&~&& SiteID: 215-000-000821 Inventory Item 0003 &&&&&&~&A&&&&&~ Facility Unit: Fixed Containers on Site HELIUM o Days On Site o 365 Location within this Facility Unit Map: Grid: MRI/ISOLATED ROOM o CAS# o 7440-59-7 i~ STATE ~%~ TYPE &&&%&& PRESSURE &&&% TEMPERATURE &&%~&&& CONTAINER TYPE Gas o Pure o Above Ambient o Ambient o FIXED PRESS. CYLINDER i~~~~~~ AMOUNTS AT THIS LOCATION Largest Container o Daily Maximum o Daily Average FT3 o 405.00 FT3 o 405.00 FT3 Maximum Stored o Maximum Open Use o Maximum Closed Use FT3 o FT3 o FT3 %Wt. o o RSo CAS# 100.00OHelium ONo o 7440597 -4- 06/16/1998 i,~KERN~RADIOLOGY MEDICAL GROUP INC ~&~&~&&~&~~ SiteID: 215-000-000821 i~ Notif./Evacuation/Medical ~~~~~&~&~~ Overall Site i~ Agency Notification ~~~~~~~~~ 07/31/1997 CALL 911 GENERAL ELECTRIC - 397-6144 CALIFORNIA IMAGING SOLUTIONS - 3101 16TH ST #110 - 337-9729 OFFICE OF EMERGENCY SERVICES - 800-852-7550 i&~& Employee Notif./Evacuation &~&~&&&&&&&&~&&&&&&&&&&~&~&&&&&&~&~ 03/11/1991 PUBLIC ADDRESS SYSTEM FIRE ALARM SYSTEM ALL EMPLOYEES TO EVACUATE BUILDING AT EXIT NEAREST THEIR LOCATION. GATHER AT NORTHWEST CORNER OF PARKING LOT FOR EMPLOYEE COUNT. ~ Public Not±f./Evacuation ~g~~g~~&~~~g~ 03/11/1991 RECEPTIONISTS RESPONSIBLE FOR PATIENTS IN WAITING ROOM. EXPEDITORS RESPOSIBLE FOR PATIENTS IN DRESSING AREAS. TECHNOLOGISTS RESPONSIBLE OR PATIENTS IN EXAM ROOMS. PHYSICIAN ON PREMISES AT ALL TIMES DURING OPEN HOURS. FULL-TIME NURSE ON STAFF HALL AMBULANCE - 805-327-4111 GOLDEN EMPIRE - 805-327-9000 MEMORIAL OR MERCY HOSPITAL OR ER ~e~e~e~~~~~~e~e~~~ee~e~e~~~~~~eeeeee~e~~~e~e~.~~e~~~~ee~ee~~eee~~~~~~~ee~~eeee~~f -5- 06/16/1998 i~ERN~RADIOLOGY MEDICAL GROUP INC~&&~&&~&&~&~ SiteID: 215-000-000821 i~ Mitigation/Prevent/Abatemt ~~~~A~~~ Overall Site i~& Release Prevention ~~~~~~&~~~ 09/09/1992 HELIUM IS STORED IN SEPARATE ISOLATED ROOM. WASTE IS STORED IN RED AIR-TIGHT HAZARDOUS CONTITIONS PROCESSING CHEMICALS IN PLASTIC CONTAINERS SPRINKLER SYSTEM THROUGHOUT BUILDING SAFETY TRAINING MANUAL FOR EMPLOYEES i~ Release Containment ~~~~~~&~~~ 09/09/1992 HAVE 50 LBS OF KITTY LITTER ON PREMISES AT ALL TIME. O~ HAVE PERMANENT HAZARDOUS WASTE CONTAINMENT AND CLEAN UP KIT. SPREAD KITTY LITTER, USE SQUEEGEE AND DUST P~. INSERT IN HAZARDOUS WASTE CONTAINER. HAVE CONTRACT WITH HAZARDOUS WASTE DISPOSAL COMPANY, (BFI MEDICAL WASTE SYSTEMS) TO REMOVE HAZARDOUS WASTE. -6- 06/16/1998 ~ERN~RADIOLOGY MEDICAL GROUP INC Site Emergency Factors ~~~~~~~~ Overall Site i~ Special Hazards ~~~~~~~~~~ 07/31/1997 RADIOISATOPES ON HAND - RADIATION HAZARD CONTAINERS ARE USED FOR ALL RADIOISOTOPES AND HAULED OFF SITE BY BFI MEDICAL WASTE SYSTEM. Utility Shut-Offs ~&~~~&&&&~~&~~&~~ 04/02/1993 A) GAS - SOUTHEAST CORNER OF BUILDING B) ELECTRICAL - SOUTHEAST CORNER OF BUILDING C) WATER - EAST SIDE OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO £~ Fire Protec./~vaii. Water PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM - FIRE EXTINGUISHER FIRE HYDRANT - N SIDE OF BLDG ON S SIDE OF ST ADJACENT TO BLDG £~ Buildin~ Occupancy Level 7 06/16/1998 ~ERN'~RADIOLOGY MEDICAL GROUP INC Training &&&&&&&&&~&&~&~&&&~&~&~&~&~&~&&~&&~~ Overall Site i~ Employee Training WE HAVE,%0 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE, AWARE OF: 1) LOCATION OF lV~TERIAL DATA SHEETS 2) USE OF FIRE EXTINGUISHERS~ 3) EVACUATION -8- 06/16/1998 MATERIAL SAFETY DATA SHEET PICKER C~# 256617. 200000404/F/USA - C-0131.3003 Approval Date: 02/14/1996 / Print Date: 02/17/1996 ~ 1, CHEMICAL PRODUCT AND COMPANY IDENTIFICATION Product Name:'KODAK RP X-OMAT Developer Replenisher Catalog Number(s): 124 9259 - To Make 10 gallons (U,S,). I25 5835 - To Make 10 gallons (JAPAN) 171 6828 - To Make 20 gallons (U.S.) 131 8989 - To Make 200 gallons (U.S.) - Part A 817 0748 - To Make 200 gallons (U.S.) - Part A 162 0509 - To Make 200 gallons (U.S.) - Parts B & C 831 7018 - To Make 5400 .gallons (U.S.) - Part B 841 4161 - To Make 5400 gallons (U.S.) - Part C 851 2295 - To Make 2400 gallons (U.S.) 859 7494 - To Make 2400 gallons (U.S.) ManUfacturer/Supplier: EASTM~ KODAK COMpANy, Rochester, New York 14650 For Emergency Health, Safety & Environmental Information, call: 716-722-5151 For other information, call (800) 242-2424. To request an MSDS, call (800) 242-2424, extension 25. Synonym(s): Part A: KAN 448589, PCD 5468, C-0131.300 Part B: K.A.N 440512, PCD 5228, C-0131.600 Part C: KA~N 440513, PCD 5250, C-0132.010 Working solution: KAN 441665, C-0133.500 2. COMPOSITION/INFORMATION ON INGREDIENTS Weight % - Component - (CAS Registry No.) Part A: 60-65 Water (007732-18-5) 20-25 Potassium sulfite (010117-38-1) 9 Hydroquinone (000123-31-9) 3 Diethylene glycol (000111-46-6) 1-5 Sodium carbonate (000497-19-8) Part B: ................................ 75-80 Acetic acid (000064-19-7) 10-15 1-phenyl-3-pyrazolidinone (000092-43-3) 5-10 Water (007732-18-5) Part C: 40-45 Water (007732-18-5) 40-45 Glutaraldehyde (000111-30-8) 5-10 Acetic acid (000064-19-7) 1-5 5-nitroindazole (005401-94-5) MATERIAL SAFETY DATA SHEET 200000404/F/USA - C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 Page 2 Working solution: 85-90 Water (007732-18-5) 5-10 Potassium sulfite (010117-38-1) 1-5 Hydroquinone (000123-31~9) 1-5 Potassium acetate (000127r08-2) 1-5 Glutaraldehyde bis(potassium bisulfite) (068310-08-7) 3. HAZARDS IDENTIFICATION Part A: WARNING] CONTAINS: Hydroquinone (000123-31-9) HARMFUL IF SWALLOWED CAUSES SKIN AND EYE IRRITATION MAY CAUSE ALLERGIC SKIN REACTION HMIS Hazard Ratings: Health - 2 , Flammability - 1, Reactivity - 0, Personal Protection - C NFPA Hazard Ratings: Health - 1, Flammability - 1, Reactivity (Stability) - 0 Part B: DANGER] CONTAINS: Acetic acid (000064-19-7), 1-phenyl-3-pyrazol~dinone (000092-43-3) CAUSES SEVERE SKIN AND EYE BURNS VAPOR EXTREMELY IRRITATING TO THE EYES AND RESPIRATORY TRACT HARMFUL IF SWALLOWED MAY CAUSE ALLERGIC SKIN REACTION COMBUSTIBLE LIQUID AND VAPOR ..... BASED ON REPEATED-DOSE INGESTION STUDIES IN ANIMALS, A MINOR COMPONENT OF THIS PRODUCT MAY CAUSE BLOOD, TESTICULAR, AND ADVERSE REPRODUCTIVE EFFECTS KMIS Hazard Ratings: Health - 3 , Flammability - 2, Reactivity - 0, Personal Protection - H NFPA Hazard Ratings': Health - 2, Flammability - 2, Reactivity.(Stability) - 0 Part C: DANGER] CONTAINS: Glutaraldehyde (000111-30-8), acetic acid (000064-19-7), 5-nitroindazole (005401-94-5) CAUSES SEVERE SKIN ~ND EYE BURNS H~MFUL IFA BSORBED THROUGH SKIN OR SWALLOWED VAPOR IRRITATING TO THE EYES AND RESPIRATORY TRACT MAY CAUSE ALLERGIC SKIN REACTION M~TERIAL SAFETY DATA SHEET 200000404/F/USA - C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 Page 3 pOTENTIAL PEROXIDE FORMER A MINOR COMPONENT OF THIS PRODUCT MAY CAUSE LIVER DAMAGE BASED ON ANIMAL DATA }{MIS Hazard Ratings: Health - 3 , Flammability - 1, Reactivity -.0, Personal Protection - H NFPA Hazard Ratings: Health - 2, Flammability - 1, Reactivity '(Stability) - 0 Working solution: ~ WARNING] CONTAINS: Hydroquinone (000123-31-9) CAUSES SKIN ~ND EYE IRRITATION MAY CAUSE ALLERGIC SKIN REACTION I~IS Hazard Ratings: Health - 1 , Flammability - 0, Reactivity - 0, Personal Protection - C NFPA Hazard Ratings: Health - 1, Flammability - 0, Reactivity (Stability) - 0 NOTE: HMIS and NFPA hazard indexes involve da~a review and interpretation that may vary among companies. They are intended only for rapid, general identification of the magnitude of the potential hazards. The personal protection index is only intended for general guidance on personal protection equipment (PPE)~that is suitable for the potential hazards of the material. PPE (e.g., respirators) may not be needed if engineering controls (e.g., local ventilation) are adequate. ~ asterisk (~), in the HMIS health field, designates potential chronic or target organ hazards. To adequately address safe handling, ALL information in this MSDS must be considered. 4. FIRST-AID MEASURES Inhalation: Move to fresh air. Treat ·symptomatically. Get medical attention if symptoms occur. Eyes: In~nediately flush With plenty of water for at least 15 minutes. Get medical attenti0~ immediately Skin: Part A & Working solution: Immediately flush with plenty of water and wash with a non-alkaline (acid) type of skin cleaner. If skin irritation or an allergic skin reaction develops, get medical attention. Remove contaminated clothing and shoes. Wash contaminated clothing before reuse. Destroy or thoroughly clean contaminated shoes. Part B & Part C: Immediately flush with plenty of water for at least M~TERIAL SAFETY DATA SHEET 200000404/F/USA - C-0131.300B Date: 02/14/1996 ~'i~ Approval Print Date: 02/17/1996 Page 4 minutes while removing contaminated clothing and shoes. Get medical attention in,mediately. Wash contaminated clothing before reuse. Destroy or thoroughly clean contaminated shoes. Ingestion: Part A: Induce vomiting as directed by medical personnel. Never give anything by mouth to an unconscious person. Call' a physician or poison control center immediately. Part B & Part C: Do NOT induce vomiting. Give Victim a glass of water. Never give anything by mouth to an unconscious person. Call a physician or poison control center immediately. Working solution: Drink 1-2 glasses of water. Seek medical attention. 5. FIRE FIGHTING MEASURES Extinguishing Media: Part A, Part B & Part C: Water spray, carbon dioxide (C02), dry chemical, alcohol foam WOrking solution: Use appropriate agent for adjacent fire. Special Fire-Fighting Procedures: Part A, Part C & Working solution: Wear self-contained breathing apparatus and protective clothing. Fire or excessive heat may produce hazardous decomposition products. Part B: Wear self-contained breathing apparatus and protective.clothing. Fire or excessive heat may produce hazardous decomposition products. Use water spray to keep fire-exposed containers cool'. Hazardous Combustion Pro'ducts: Part A: Carbon dioxide, carbon monoxide, oxides of sulfur Part B: Carbon dioxide, carbon monoxide, oxides of nitrogen Part C: Carbon dioxide, carbon monoxide Working solution: None (noncombustible), (see also Hazardous Decomposition Products section) Unusual Fire and Explosion Hazards: Part A: & Working solution: None MATERIAL SAFETY DATA SH 200000404/F/USA - C-0131.300B Approval Date: 02/14/1996 Print 'Date: 02/17/1996 Page 5 Part B: Classified as combustible. Material contains a combustibl'e solvent that may accumulate in the container headspace. Part .C: May form. peroxides of unknown stability. May cause spontaneous " heating and ignition when absorbed on combustible, porous material (e.g. ~ hi g) . o rags, paper, sawdust, cotton, clot n . . . ~ 6 ACCIDENTAL RELEASE MEASURES : '...i ~ May require neutralization if pH < 2.0 or > 12.5. Flush to sewer with large amounts of water. Otherwise, absorb spill with vermiculite or other inert material, then place in a container for chemical waste. Clean surface " thoroughly to remove residual contamination. Part B: Eliminate all ignition sources' 7. HANDLING AND STORAGE Personal Precautionary Measures: Part A & Working solution: Avoid contact with eyes, skin, and clothing. Use · with adequate ventilation. Wash thoroughly after handling. The routine use of a nonalkaline (acid) type of hand cleaner and regular cleaning of working surfaces, gloves, etc. will help minimize the possibility of a skin reaction. Part B: Do not get in eyes, on skin, on,clothing. Do not breathe vapor. Use · only with adequate ventilation. Wash thoroughly after handling. Part C: Do not get in eyes, on skin, on clothing. Avoid breathiqg vapor. Use with adequate ventilation. Wash thoroughly after handling. Prevention of Fire and Explosion: Part A: Keep from contact with oxidizing materials. Part B: Keep f~0m_c.ontact with..o~idizing materials. Keep away 'from heat and flame. Part C: Keep from contact with oxidizing materials. Minimize 'exposure to air. If peroxide formation is suspected, do not open or move container. Remove and wash contaminated clothing promptly. Working solution: No special precautionary measures should be needed under anticipated conditions of use. Storage: MATERIAL SAFETY DATA SHEET '200000404/F/USA - C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 I' Page 6 Part A, Part B & Working solution: Keep container closed. Keep away from incompatible substances (see Incompatibility section). Part C: Keep container tightly closed. Store away from heat and light. 8. EXPOSURE CONTROLS/PERSONAL PROTECTION Exposure Limits: ACGIH Threshold Limit Value (TLV): Acetic acid: 10 ppm TWA: 15 ppm STEL Glutaraldehyde: 0.2 mg/m3 Ceiling Hydroquinone: 2 mg/m3 TWA Eastman Kodak Company industrial hygiene guideline: 1-phenyl-3-pyrazolidinone: 0.2 mg/m3 TWA OSHA (USA) Permissible Exposure Limit (PEL - 1971 Table Z-1 Values): Acetic acid: 10 ppm TWA Hydroquinone: 2 mg/m3 TWA 'Ventilation: Good general ventilation (typically 10 air changes per hour) should be used. Ventilation rates should be matched 'to conditions. Use process enclosures, local exhaust ventilation, or other engineering controls to maintain airborne levels below recommended exposure limits. Respiratory Protection: Part A & Working solution: None should be needed. Part B.: If engineering controls do not maintain airborne concentrations below recommended exposure limits, an approved respirator must be worn. Respirator type: Organic vapor, acid gas..If respirators are used, a program should be instituted to assure compliance with OSHA Standard 29 CFR 1910.134. . Part C: If engineering controls do not maintain airborne concentrations below reco~mended exposure limits, an approved respirator must be worn. Respirator type: Organic vapor. If respirators are used, a program should be. instituted to assure compliance with OSHA Standard 29 CFR 1910.134. Eye Protection: Part A & Working solution: Wear safety glasses with side shields (or goggles). MATERIAL SAFETY DATA SHEET 200000404/F/USA - C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 .Page 7 Part B & Part C: Wear safety glasses with side shields (or goggles) and a face shield. Skin Protection: Wear impervious gloves and protective clothing appropriate for the risk of exposure. Recommended Decontamination Facilities: Eye bath, safety shower, washing facilities 9. PHYSICAL AND CHEMICAL PROPERTIES Part A Part B Part C Working solution Physical Form: liquid liquid liquid liquid Color: light yellow orange yellow- yellow green Odor: odorless pungent aldehyde slight Specific Gravity 1.317 1.081 1.127 1.082 (water = 1): Vapor Pressure 24 mbar 24 mbar 24 mbar 24 mbar at 20 C (68 F): (18 mm Hg) (18 mm Hg) (18 .mm Hg) (18 mm Vapor Density 0.6 1.7 1.8 0.6 (Air = 1)~ Volatile 60-65% 85-90% 95-99% 85-90% Fraction by Weight: ~Boiling Point: >100 C not available >100 C >t00 C (>212 F) (>212 F) (>212 F) Solubility in _complete ......... complete complete complete Water: pH: 11.4 < 1.0 2.7 10.2-10.4 Flash Point: none 57 C (134 F) none none, noncombustible liquid M~kTERIAL SAFETY DATA SHEET 200000404/F/USA - C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 Page 8 10. STABILITY AND REACTIVITY Stability: Part A, Part B~'& Working solution: Stable Part C: Normally stable; however, on long term storage, materials containing similar functional groups form peroxides of unknown stability. Incompatibility: Part A: Strong oxidizing agents, strong acids Part B: Strong oxidizing agents, bases Part C: Strong oxidizing agents Working solution: Strong acids Hazardous Decomposition Products: Working solution: Sulfur dioxide Hazardous Polymerization: Part A, Part B & Working solution: Will not occur. Part C: Nonhazardous polymerization may occur. Avoid initiators, accelerators, heat, pressure, contamination. 11. TOXICOLOGICAL INFORMATION Effects of Exposure: General: Part B: Based on repeated-dose ingestion studies in animals, 1-phenyl-3-pyrazolidinone, a minor component of this product may cause blood, testicular,.-.and adverse-P.reproductive effects. Part C: Possible risk of respiratory and skin sensitization. A minor component of this product, 5-nitroindazole, may cause liver damage based on animal data. Inhalation: Part A & Working solution: Expected to be a low hazard for reco~nended handling. MATERIAL SAFETY DATA SHEET 200000404/F/US^ - C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 Page 9 Part B: Vapor extremely irritating. May cause irritation to the mucous membranes and upper respiratory tract. .'. Part C: Vapor irritating. Although it is known that glutaraldehyde is a respiratory tract irritant and may aggravate pre-existing asthmatic disorders, the supporting data for respiratory sensitization are less ~ conclusive. ~ Ey ~ es: ~ Part A & Working solution: Causes irritation.. ~,'? Part B: Causes severe burns. Vapor extremely irritating. Part C: Causes severe burns. Vapor irritating. Skin: Part A & Working solution: Causes irritation. May cause allergic skin reaction. Part B & Part C: Causes severe burns. May cause allergic skin reaction. Ingestion: Part A: Harmful if swallowed. May cause irritation of the gastrointestinal tract. Part B & Part C: Harmful if swallowed. May cause burns of the gastrointestinal tract if swallowed, Working solution: Expected to be a low ingestion hazard. May cause irritation of the gastrointestinal tract. Data for 1-phenyl-3-pyrazolidinone: Acute Toxicity 'Data: Oral LD-50 (male rat): 476 mg/kg ' ' 0ral LD-50 (female_rat): 336 .mg/kg Dermal LD-50: · 1000 mg/kg, estimated Skin irritation: slight irritation Repeated skin application: slight irritation Skin sensitization: slight Eye irritation (unwashed eyes)- slight irritation Definitions for the following section(s): LOEL = lowest-observed-effect level, NOAJ~L = no observed-adverse-effect level, NOEL = no-observed-effect level. HATERIAL SAFETY DATA SHEET 200000404/F/USA - C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 .. Page 10 Subchronic Toxicity Data: Oral study (90 days, rat): LOEL = 0.32 % in diet (target organ'effects: testes) LOEL ~ 0.08 Z in diet (reduced feed intake) LOEL = 0.02 % in diet (target organ effects: red blood cell) NOEL = not.established 12. ECOLOGICAL INFORMATION Introduction: This environmental effects summary is written to assist in addressing emergencies created by an accidental spill which might occur during the .shipment. of this material, and, in general, it is not meant to address discharges t'o sanitary sewers or publically owned treatment works. Summary: Data for the major components of this material have been used to estimate the environmental impact of this material. However, this material, itself, has not been tested for'environmental effects. Part A: This material is a strongly alkaline aqueous solution, and this property may cause adverse environmental effects. It is expected to have the following properties: a moderate bi'ochemical oxygen demand and may cause oxygen depletion in aqueous systems, a high potential to affect some aquatic organisms, a moderate.potential to affect secondary waste treatment microbial metabolism, a low potential to affect the germination and/or early growth of some plants, a low potential to bioconcentrate. After dilution with a large amount of water, followed by secondary waste treatment, 'this material is not expected to cause adverse environmental effects'. Part B: This material is a strongly acidic aqueous solution, and this property may cause adverse environmental effects. It is expected to have the following properties: a high biochemical oxygen demand and a potential to cause oxygen depletion in aqueous systems, a high potential to affect some aquatic organisms, a high-.~potential to'laffect secondary waste treatment microbial metabolism, a high potential to affect the germination and/or early growth of some plants, a low potential to persist in the environment, a low potential to bioconcentrate. After dilution with a large amount of water, followed by secondary waste treatment, this material is not expected to cause adverse environmental effects. Part C: This material is a moderately acidic aqueous solution, and this property may cause adverse environmental effects. It is expected to have the following KATERIAL SAFETY DATA SHEET 200000404/F/USA - C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 Page 11 properties: a low biochemical oxygen demand and little potential to cause oxygen depletion in aqueous systems, a moderate potential to affect some aquatic organisms, a moderate potential to affect secondary waste treatment microbial metabolism, a moderate potential to affect the germination and/or early growth of some plants, a high potential to biodegrade (low persistence) with unacclimated microorganisms from activated sludge, a low potential to persist in the environment, a low potential to bioconcentrate. After dilution with a large amount of water, followed by secondary waste treatment, this material is not expected to cause adverse environmental effects. 13. DISPOSAL CONSIDERATIONS Discharge, treatment, or disposal may be subject to national, state, .or local laws. May require neutralization if pH < 2.0 or pH > 12.5. Part A & Working solution: Flush 'to sewer with large amounts of water. Part B & Part C: Flush to sewer with large amounts of water. Since emptied con~tainers retain product residue, follow label warnings even after container is emptied. 14. TRANSPORT INFORMATION - For transportation information regarding'this.product, call the Kodak Information Center: (800) 242-2424 between 8 a.m. and 8 p.m. (Eastern Standard Time), Monday through Friday. 15. REGULATORY INFORMATION - Material(s) known to the State of California to cause cancer: None - Material(s) known to the State of California to cause adverse reproductive effects: None - Carcinogenicity Classification (components present at 0.1% or more): - International Agency for Research on Cancer (IARC): None - American Conference_of Governmental Industrial Hygienists (ACGIH): Ngne - National Toxicology Program (NTP): None - Occupational Safety and Health Administration (OSHA): None - Chemical(s) subject to the reporting requirements of Section 313 or Title III of the Superfund Amendments and Reauthorization Act (SARA) of 1986 and 40 CFR Part 372: Hydroquinone MATERIAL SAFETY DATA SHEET 200000404/F/USA - C-0:3:.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 Page 12 16. OTHER INFORMATION US/Canadian Label Statements: Part A: CONTAINS: Hydroquinone (000123-31-9) WARNING] HARMFUL IF SWALLOWED CAUSES SKIN ;dqD EYE IRRITATION MAY CAUSE ALLERGIC SKIN REACTION Avoid contact with eyes, skin, and clothing. Wash thoroughly after handling. FIRST AID: If swallowed, induce vomit£ng inmnedSately as directed by medical personnel. Never give anything by mouth to an unconscious person. In case of eye contact, immediately flush eyes with plenty of water for at least 15 minutes. In case of skin contact, wash skin with soap and plenty of water. Call a physician or poison control center immediately..Remove cont~ninated clothing and shoes. Wash contaralnated clothing before reuse. Destroy or thoroughly clean contaminated shoes. Keep out of reach of children. For additional information, see Material Safet~ Data Sheet (MSDS) for this material. Additional hazard precautions for containers er than 1 gallon of liquid or 5 pounds of solid: Since emptied containers retain product residue, follow label warnings even after container is emptied. IN CASE OF FIRE: Use water spray, dry chemica,1, carbon dioxide (C02) alcohol foam. Part B: CONTAINS: Acet.ic-"-acid (000064~19-7), 1-phenyl-3.-pyrazolidinone (000092-43-3) DANGER] CAUSES SEVERE SKIN AND EYE BURNS VAPOR EXTR EL IRRITATING TO EYES AND RESPIRATORY TRACT H~MFUL IF SWALLOWED MAY CAUSE ALLERGIC SKIN REACTION ~HA~LS,' COMBUSTIBLE LIOUIDAND VAPOR BASED ON REPEATED-DOSE INGESTION STUDIES IN ANI A MINOR COHPONENT OF THIS PRODUCT MAY CAUSE BLOOD, TESTICULAR, AND ADVERSE REPRODUCTIVE EFFECTS ~TERIAL SAFETY DATA SH 200000404/F/USA - C-0131.300B Approval Date: 02/14~1996 Print Date: 02/17/1996 Do not breathe vapor. D0 not get in eyes, on skin, on clothing. Use only with adequate ventilation. Keep away from heat and flame. " Keep container closed; .... Wash thoroughly after handling. o FIRST AID: If swallowed, do NOT induce vomiting-, Give victim a glass of ~ water. Never give anything by mouth to an unconscious person. If inhaled, "~ move to fresh air. Treat symptomatically. In case of contact, immediately .~ Y flush eyes and skin with plenty of water for at least 15 minutes while . ~ removing contaminated clothing and shoes. Call a physician or poison control center immediately. Wash contaminated clothing before reuse. ..~' Destroy or thoroughly clean contaminated shoes. Keep out of reach 0f children.' ' Do not handle or use until safety precautions in Material Safety Data Sheet (MSDS) have been read and understood. Additional hazard precautions for containers greater than 1 gallOn of liquid or 5 pounds of. solid: Since emptied containers retain product residue, follow label warnings even after container is emptied. IN CASE OF FIRE: Use water spray, foam, dry chemical, carbon dioxide (C02). Use water spray to keep fire-exposed containers cool. IN CASE OF SPILL: Eliminate all ignition sources. Use for NYC SHIPMENTS: CAUTION] Combustible Mixture N.Y.F.D.C. of A. No. 1621 (for shipments to NYC) Part C: · .. CONTAINS:. Glutaraldehyde (000111~30-8), acetic acid (000064-19-7), 5-nitroindazole (005401-94-5) DANGER] CAUSES SEVERE_SKIN.~AND EYE--BURNS_ F-4RMFUL IFABSORBED THROUGH SKIN OR SWALLOWED VAPOR IRRITATING TO THE EYES AND RESPIR~kTORY TRACT MY CAUSE ALLERGIC SKIN REACTION POTENTIAL PEROXIDE FORMER A MINOR COMPONENT OF THIS PRODUCT MAY CAUSE LIVER DAMAGE BASED ON ANIMAL DATA Do not get in eyes, on skin, on clothing. Keep container tightly closed. Store away from heat and light. MATERIAL SAFETY DATA SHEET 200000404/F/USA --C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 Page 14 Do not allow to evaporate to near dryness. Keep from contact with clothing and other combustible materials. Remove and wash contaminated clothing promptly. Avoid breathing vapor. Use with adequate ventilation. Wash thoroughly after handling. FIRST AID: If swallowed, do NOT induce vomiting[ Give victim a glass of water. Never give anything by mouth to an unconscious person. If inhaled, move to fresh air. Treat symptomatically. In case of contact, immediately flush eyes and skin with plenty of water for at least 15 minutes while removing contaminated clothing and shoes. Call a physician or poison control center immediately. Wash contaminated clothing before reuse. Destroy or thoroughly clean contaminated shoes. Keep out of reach of children. Do not handle or use until safety precautions in Material Safety Data Sheet (MSDS) have been read and understood. Additional hazard precautions for containers greater than 1 gallon of liquid or 5 pounds of solid: Since emptied containers retain product residue, follow label warnings even after Container is emptied. IN CASE OF FIRE: Use water spray, dry chemical, carbon dioxide (C02), alcohol foam. Working solution: CONTAINS: Hydroquinone (000123-31-9) CAUSES SKIN AND EYE IRRITATION " MAY. CAUSE ALLERGIC SKIN REACTION Avoid contact with eyes, skin, and clothing. Wash thoroughly after handling. FIRST AID: In case of eye contact, immediately flush eyes with plenty of water for at least 15 minutes. In case of skin contact, wash. skin with soap and plenty of water. Get medical attention if symptoms occur. Remove contaminated clothing and shoes. Wash contaminated clothing before reuse. Destroy or thoroughly clean contaminated shoes. Keep out of reach of children. For additional information, see Material Safety Data Sheet (MSDS) for this material. MATERIAL SAFETY DATA SH 200000404/F/USA - C-0131.300B Approval Date: 02/14/1996 Print Date: 02/17/1996 Page 15 Additional hazard precautions for containers greater than i gallon of liquid or 5 pounds of solid: Since emptied containers retain product residue follow label warnings even after container is emptied. PICKER INTERNATIONAL MATERIAL SAFETY DATA SHEET Issue Date July 1996 Catalog Number 268381 FOR EMERGENCY ASSISTANCE CALL CHEMTREC (800_) 424-9300 (24 HOURS) 1. CHEMICAL PRODUCT AND COMPANY IDENTIFICATION DEVELOPER SYSTEMS CLEANER (Parts A & B ) and NEUTRALITER & Working Solutions Package Size: 2 sets to make 2 x 3 gallons ( 6 gallons ) ManufactUrer/Supplier: PICKER INTERNATIONAL, Cherry Hill, NJ 08003 U.S.A. Phone (609) 424-3620 8:30 am - 5:00 pm EDT Monday - Friday 2. COMPOSITION/INFORMATION ON INGREDIENTS Ingredient %Weight/ CAS Reg.# ACGIIt OSllA Target Volume TLV PEL Organ (s) Water 95 - 100 7732-i8-5 .... None Listed Potassium Permanganate 1 - 5 7722-64-7 5 rog/m3 5 rog/m3 E, S Water 80 - 85 7732-18-5 .... None Listed Sulfuric Acid 15 - 20 7664-93-9 1 mg/m3 1 mg/m3 E, S, CLEANER Working Solution********************************************************* Water 80 - 90 7732-18-5 .... None Listed Potassium Permanganate less than 1 7722-64-7 5 rog/m3 5 rog/m3 E, S Sulfuric Acid 1 - 5 7664-93-9 1 rog/m3 1 rog/m3 E, S Water 75 - 85 7732-18-5 .... None Listed Sodium Bisulfite 25 - 30 7631-90-5 5 rog/m3 5 rog/m3 . R, E, S Sodium Sulfite 10 - 15 7757-83-7 .... None Listed Water 95 - 100 7732-18-5 .... None Listed Sodium Bisulfite 1 - 5 7631-90-5 5 rog/m3 5 rog/m3 R, E, S Sodium Sulfite 1 -5 · 7757-83-7 .... None Listed TLV/PEL'S · C = Ceiling Value Target Organ (s): R = Respiratory System; S = Skin; E = Eyes; K = Kidneys; T = Teeth C = Central Nervous System; L = Liver NONE OF THE ABOVE COMPONENTS ARE LISTED BY IARC, NTP OR OSHA AS A CARCINOGEN Page 1 of 6 3. HAZARDS IDENTIFICATION )PER SYSTEMS CLEANER & NEUTRALIZER ' Catalog Number 268381 Issue Date: July 1996 Page 2 o~ CLEANER Part A:Purple liquid with no odor that contains potassium permanganate. HARMFUL IF SWALLOWED, CAUSES EYE IRRITATION. ItMIS Hazard Rating '.Flammability - 0, Reactivity - 0, Health - 1, Protection - B CLEANER Part B:Col6~les's liquid no odor that contains sulfuric acid. " ~" HARMFUL'IF SWALLOWED, MAY CAUSE EYE AND SKIN IRKITATION. ltMIS HaZard Rating'Flammability - 0, Reactivity - 0, Health - 1, Protection - B CLEANERWorking Solution:Purple colored liquid with no odor that contains sulfuric acid. HARMFUL IF SWALLOWED, MAY CAUSE EYE AND SKIN IRRITATION. ItMIS Hazard Rating~lammability - 0, Keactivity - 0, Health - 1, Protection - B NEUTRALIZER Concentrate:Colorless liquid with slight odor that contains sodium bisulfite. HARMFUL IF SWALLOWED, MAY CAUSE SKIN AND EYE IRRITATION. ItMIS Hazard Rating~lammability - 0, Reactivity - 0, Health - 2, Protection - B NEUTRALIZER Working Solutiontgolorless liquid with slight odor that contains sodium bisulfite. HAKMFUL IF SWALLOWED, MAY CAUSE SKIN AND EYE IKKITATION. ItMIS Hazard Rating:Flammability - 0, Reactivity - 0, Health - 1, Protection - B 4. FIRST AID MEASURES Inhalation: Move to fresh air, obtain medical attention if required. Eye Contact: Hold eyelids apart and immediately flush eyes with plenty of water for 15minutes. Get medical attention. Skin Contact: Immediately flush with plenty of water while removing contaminated clothing and shoes. Launder contaminated clothes and shoes prior to reuse. If skin irritatidfi'-6~ an allergl-d ~ldh'-~eaction develops get medical attention. Ingestion: Cleaner Part A:Drlnk 1-2 glasses of water. Obtain medical care immediately. Cleaner Part B: Do not induce vomiting. Drink 1 - 2 glasses of water. Never give anything by mouth to an unconscious person. Obtain medical care and hospital treatment immediately. NEUTRALIZER:Drink 1 - 2 glasses of water. Obtain medical care immediately. Working Solutions:Drink 1 - 2 glasses of water, get medical attention. ~. I'~I)EVELOPER SYSTEMS CLEANER & NEUTRALIZER ' Catalog Number 268381 L Issue Date: July 1996 Page 3 of 6 I I I 5. FIRE FIGHTING MEASURES Extinguishing Media:Water spray, dry chemical, carbon dioxide (CO2) or alcohol foam. Equipment:Wear self-contalned breathing~apparatus and protective clothing to prevent contact with ~. - skin and eyes. Hazardous Combustion Productsblone Unusual Fire and Explosion HazardsNone Flash Points:None 6. ACCIDENTAL RELEASE MEASURES. CLEANER Part A:Flush to sewer'with large amount of water. : CLEANER Part B:Neutralize with sodium bicarbonate, flush to sewer with large amount of water. NEUTRALIZER Flush to sewer with large amount of water. Working Solution:Flush to sewer with large amount of water. Otherwise, absorb spill with vermiculite or other suitable absorbent and place in impervious container for disposal in an approved and permitted landfill, Clean area thoroughly to remove residual contamination. 7. HANDLING AND STORAGE Avoid contact with eyes, skin and clothing. Store between 10 - 25' C (50 - 80' F).. Protect shipments from freezing (Keep above 4.4' C (40' F)) 8. EXPOSURE CONTROLS/PERSONAL PROTECTION Engineering Controls Good general ventilation ( 10 room volumes per hour) should be sufficient to' control airborne levels below recommended exposure limits when product is used as intended. Respirators:Should not be required. - ........ Eye Protection:Chemical splash goggles or face shield. Skin Protection:Impervious gloves (nitrile rubber). ~OEVELOPER SYSTEMS CLEANER & NEUTRALIZER Catalog Number 268381 9_ ~Issue Date: July 1996 Page 4 of 6 i PHYSICAL AND CHEMICAL PROPERTIES CLEANER * NEUTRALIZER Working * Working Part A PartB Solution * Concentrate Solution Physical Stage liquid liquid liquid * liquid liquid Color .- purple colorless purple * colorless colorless Odor none none none * slight slight Specific Gravity 1.4 1.3 1.1 * 1.3 1.1 pH 7 less than 2 leSs than 2 * 5 - 7 5 - 7 Solubility in water complete complete complete * complete complete Flash Point none none none * none none Vapor density, vapor pressUre, evaporation rate, boiling point and odor threshold leVels not known.I ' 10. STABILITY AND REACTIVITY. Stability: All solutions stable under normal ambient and anticipated storage and handling conditions of temperature and pressure. Incompatability: CLEANER Part A:Strong reducing agents. CLEANER Part B:Strong bases. Working solution:Strong bases and reducing agents. . NEUTRALIZER: Strong acids. Working Solutions:Strong acids. Hazardous Decomposition Products: CLEANER Part A:None CLEANER Part B: Sulfur dioxide ' ' Working Solution :Sulfur dioxide NEUTRALIZER: Sulfur di-~-~d'd~' Working Solution:Sulfur dioxide Hazardous PolymerizationWill not occur with any solution. 11. TOXICOLOGICAL INFORMATION Eye effects CLEANER Part A:Causes irritation CLEANER Part B:Causes bums WOrking Solution:May cause severe irritation or bums ~DEVELOPER SYSTEMS CLEANER & NEUTRALIZER Catalog Number 268381 Issue Date: July 1996 Page 5 of 6 ! ~ Ill I I I NEUTRALIZER:May cause irritation. Working Solution:Causes irritation Skin effects CLEANER Part A:May cause irritation. CLEANER Part B:May cause skin burns. Working Solution:Causes irritation NEUTRALIZER:None Known Working Solution:None Known. Oral effects: CLEANER Part A:May cause irritation of the gastrointestinal tract. CLEANER Part B:May cause bums o£ the gastrointestinal tract. Working SolutiOn:Harmful if swallowed. May irritate the gastrointestinal tract. NEUTRALIZER:Low hazard Working Solution:Low hazard Inhalation'effects: ALL SOLUTIONS:Low hazard 12. ECOLOGICAL INFORMATION Summary:Cleaner Working Solution and Part B have pH?s (see Section 9) that may cause adverse environmental effects Once neutralized and diluted these effects will be lessened substantially. 13. DISPOSAL CONSIDERATIONS Discharge? treatment, or disposal may be subject to certain government regulations. See Section 6 - Accidental Release Measures 14. TRANSPORTATION I~'tRMATI~6~ DOT: Sulfuric Acid, 8, UN2796, PG Il Quantity per package = 2 x 1 quart (2 x 946 mls.) 15. REGULATORY INFORMATION Chemicals subj eot to the reporting requirements of Section 313 of Title 111 of the Sup effund Amendm eats and Reauthorizafion Act (SARA) of 1986 aad 40 CFR Part 372: Sulfuric acid ( I DEVELOPER SYSTEMS CLEANER & NEUTRALIZER Catalog Number 268381 LIssue Date: July 1996 Page 6 of 6 I II 6. OTHER, INFORMATION Prepared by: Engineering Dept. - Picker International, HCP, Cherry I-1i11, N.J., U.S.A. Phone Number: (609) 424-3620 Date: July 1996 PICKER LNTERNATIONAL MATERIAL SAFETY DATA SHEET Issue Date September 1996 Catalog Number 252196 FOR EMERGENCY ASSISTANCE CALL (~HEMTREC (800) 424-9300 (24 HOURS) 1. CHEMICAL PRODUCT AND COMPANY IDENTIFICATION SPECTRA Developer Replenisher Parts A, B, C & Working Solution ( 200 gallon size) Manufacturer/Supplier: PICKER INTEP~ATIONAL, Cherry Hill, NJ 08003 U.S.A. Phone(609) 424-3620 8:30 am - 5:00 pm EDT Monday - Friday - 2. COMPOSITION/INFORMATION ON INGREDIENTS Ingredient %Weight/ CAS Reg.# ACGIlt OSHA Target Volume TLr PEL Organ (s) Part A ***************************************************************************** Water 40 - 70 7732-18-5 .... None Listed Potassium Sulfite 10 - 15 10117-38-1 .... None Listed Sodium Sulfite 10 - 15 7757-83-7 .... None Listed Hydroquinone 5 - 10 123-31-9 2 mt/m3 2 mt/m3. E, R, S, C Potassium Hydroxide 1 - 5 1310-58-3 2mg/m3 C 2 mg/m3 C E, R, S Potassium Carbonate 1 - 5 584-08-7 ' - E,R, S Water 35 - 45 7732-18-5 .... None Listed Acetic Acid 30 - 40 64-19-7 10 ppm 10 ppm R, S, E, T Diethylene Glycol 20 - 30 111-46-6 .... C,K,L,E,S 1-Phenyl-3-Pyrazolidone 3 - 7 92-43-3 .... None Listed Part C ***************************************************************************** Water 60 - 80 7732-18-5 .... None Listed Glutaraldehyde 10 - 15 111-30-8 0.2 ppm C 0.2 ppm C tL S, E Glutaraldehyde- Sodium Bisulfite 20 - 30 7420-89-5 .... E, R, S Working Solution******************************************************************** Water 85- 90 7732-18-5 -- -- · NoneListed .- Potassium Sulfite 1 - 5 10117-38-1 .... None Listed Sodium Sulfite 1 - 5 7757-83-7 .... None.Listed Hydroquinone - -- 1..- 5 ...... 123-31-9 2 mt/m3 2 mt/m3 E, Ps S, C Potassium Hydroxide 1 - 5 1310-58-3 2 mt/m3 C 2 rog/m3 C E, R, S Potassium Carbonate 1 - 5 584-08-7 .... E, R, S Glutaraldehyde- Sodium Bisulfite 1 - 5 7420-89-5 .... E, R, S TLV/PEL'S: C = Ceiling Value Target Organ (s): R = Respiratory System; S = Skin; E = Eyes; K = Kidneys; T = Teeth C = Central Nervous System; L = Liver NONE OF THE ABOVE COMPONENTS ARE LISTED BY IARC, NTP OR OSHA AS A CARCINOGEN Page 1 of 6 Developer Replenisher Catalog Number 252196 Issue Date: September 1996 Page 2 of 6 3. HAZARDS IDENTIFICATION Part A: Colorless to Brown liquid that contains Hydroquinone and Potassium Hydroxide. HARMFUL IF SWALLOWED, CAUSES SKIN AND EYE IRRITATION AND MAY CAUSE ALLERGIC SKIN REACTION. ,. HMIS Hazard Rating '.Flammability - 0~ Reactivity - 0, Health - 1, Protection - B .... Part B: Orange/Brown liquid with strong offensive odor (Strong Vinegar) that would be considered an Environmental Hazard due to it's low pH (acidic). Tills PRODUCT CONTAINS ACETIC ACID WHOSE VAPOR IS IRRITATING TO THE UPPER RESPIRATORY TRACT AND MAY PUT PERSONS WHO HAVE CHRONIC RESPIRATORY, SKIN OR EYE DISEASE AT AN INCREASED RISK. MAY CAUSE EYE BURNS AND SKIN IRRITATION. HARMFUL IF SWALLOWED. HMIS Hazard Rating:Flammability - 0, Reactivity - 0, Health - 2, Protection - B Part C: Clear to Yellow liquid with sharp odor of Glutaraldehyde. CAUSES EYE BURNS, HARMFUL IF SWALLOWED, VAPOR I/LKITATING TO TH~ EYES AND RESPIRATORY TRACT AND MAY CAUSE ALLERGIC SKIN REACTION. HMIS Hazard Rating'Flammability - 0, Reactivity - 0, Health - 2, Protection - B Working Solution: Pale Yellow to Brown liquid with no appreciable smell that contains Hydroquinone and Potassium Hydroxide. CAUSES SKIN AND EYE BKR/TATION AND MAY CAUSE ALLERGIC SKIN REACTION. HMIS Hazard Rating'Flammability - 0, Reactivity - 0, Health - 1, Protection - B ,. 4. FIRST AID MEASUREs Inhalation: Move to fresh air, obtain medical attention if required. ' Eye Contact: Hold eyelids apart and immediately flush eyes with plenty of water for 15 minutes. Get medical attention. Skin Co nta ct: Immediately flush with plenty of water while removing contaminated clothing and shoes. Launder contaminated clothes prior to reuse. Discard contaminated shoes. Part A: Wash with a non-alkaline (acid) skin cleaner, if skin irritation or an allergic skin reaction develops get medical attention. Part B: Get medical attention if irritation persists. Developer Replenisher Catalog NumberS~196 Issue Date: September 1996 Page 3 of 6 Part C: If skin irritation or an allergic skin reaction develops get medical attention. Ingestion: Part A: Induce vomiting as directed by medical personnel. Never give anythingby mouth to an unconscious person. Obtain medical care and hospital treatment ..... · ~, immediately. Part B: Do not induce vomiting. Give large amounts of water. Never give anything by mouth to an unconscious person. Obtain medical care and hospital treatment immediately. Part C: Do not induce vomiting. Give large amounts of water. Never give anything by mouth to an unconscious person. Obtain medical care and hospital · treatment immediately. Working Solution:Drink 1 - 2 glasses of water, get medical.attention. 5. FlllE FIGHTING MEASURES Extinguishing Media:Water spray, dry chemical, carbon dioxide (CO2) or alcohol foam. Equipment: Wear self-contained breathing apparatus and protective clothing to prevent contact with skin and eyes. Hazardous combustion ProductsExcessive heat may produce hazardous decomposition products. Part A: Carbon dioxide, carbon monoxide, oxides of sulfur. Part B: Carbon dioxide, carbon monoxide, oxides of nitrogen. Part C: Carbon dioxide, carbon monoxide, oxides of sulfur. Working Solution:Oxides of sulfur. Unusual Fire and Explosion ltazardsNone Flash.Points: See section 9 6. ACCIDENTAL RELEASE MEASURES Flush to sewer with large amount of water - May require neutralization ifpH below 3 or above 12. Part A: pH below 12 Part B: Neutralize with sodium bicarbonate (baking soda). Part C: Neutralize with sodium bisulfite. Working Solution:pH 10.0 - 10.5. Otherwise, absorb spill with vermiculite or other suitable absorbent and place in impervious container for disposal in an approved and permitted landfill. Clean area thoroughly to remove residual contamination. Developer Replenisher Catalog Number 252196 Issue Date: September 1996 Page 4 of 6 7. HANDLING AND STORAGE Avoid contact with eyes, skin and clothing. Store between 10 - 21i~ (50 - 80° F). Protect shipments from freezing (Keep above 4°.4~ (40° F)) 8. ExPosURE coN~TRoLs/PERSONAL PROTECTION Engineering Controls Good general ventilation ( 10 room volumes per hour) should be sufficient to control airborne levels below recommended exposure limits when product is used as intended. I/product is used in any other manner local exhaust ventilation may be necessary to control any air contaminants, to within their TLV's (see section 2), during the use of this product. In addition the availability of an OSHA/MSHA air purifying respirator should be considered when large quantities of product are being handled. · · · Respirator Types: Part A: None should be required.: Part B: Organic vapor, acid gas (acetic acid). Part C: Organic Vapor (glutaraldehyde). Working solution:None should be required. If respirators are used, a program to comply with OSHA Standard 29 CFR 1910.134 must be instituted. Eye Protection:Chemical splash goggles or face shield. Skin Protection:Impervious gloves (nitrile rubber). 9. PHYSICAL AND CHEMICAL PROPERTIES Part A Part B Part C Working Solution Physical State liquid liquid liquid .. liquid Color yellow/brown orange/black yellow 'yellow/brown Odor none pungent aldehyde slight Specific Gravity 1.3. 1.1 1.2 1.1 pH 11.2 .............. 2 3 10 10.3 Solubility in water complete complete complete complete Flash Point none above 200' F none none Vapor density, vapor pressure, evaporation rate, boiling point and odor threshold levels not known. 10. STABILITY AND REACTIVITY Stability: All solutions stable under normal ambient and anticipated storage and handling Conditions of temperature and pressure. Developer Replenisher Catalog Number 252196 Issue Date: September 1996 Page 5 of 6 Incompati~ility: Part A: Strong oxidizing agents and acids. Part B: Strong oxidizing agents and bases. .~ Part C: Strong oxidizing' agents and polymerization initiators. ' Working Solutions:Strong acids Hazardous Decomposition Products: Part A: Sulfur dioxide Part B: Carbon dioxide, carbon monoxide and oxides of nitrogen may be present. Part C: Carbon dioxide, carbon monoxide and oxides of sulfur. Working Solution:Oxides of sulfur. tIazardous PolymerizationWill not occur with any solution. 11. TOXICOLOGICAL INFORMATION Eye effects Part A: Causes irritation Part B: May causes bums - Vapor irritating Part C: May causes bums - Vapor irritating Working Solution:Causes irritation Skin effects 'Part A: Causes irritation - May cause allergic skin reaction. Part B: Causes irritation Part C: Causes irritation - May cause allergic skin reaction. Working Solution:Causes irritation - May cause allergic skin reaction/. Oral effect~ ' Part A: Harmful if swallowed. May cause irritation of the gastrointestinal tract. Part B: Harmful if swallowed. May cause burns of the gastrointestinal tract. Part C: Harmful if swaLlowed.-May cause burns oft he gastrointestinal tract. Working Solution:May cause irritation of the gastrointestinal tract. Inhalation effects: Part A: None known Part B: Vapor irritating. May cause irritation of the upper respiratory tract. Part C: Vapor irritating. May cause irritation of the upper respiratory tract. Working Solution:None known Chronic Effects:Part B contains acetic acid which may put persons who have chrome respiratory, skin or eye disease at an increased risk. Developer Replenisher Catalog Number 252196 Issue Date: September 1996 ]Page 6 of 6 12. ECOLOGICAL INFORMATION Summary:These solutions have pH's (see Section 9) that may cause adverse environmental effects. Once neutralized and diluted these effects will be lessened substantially. Aquatic .TOxicity: Part A: Hydroquinone - 96 hr LC-50 (fathead minnow) 0.044 - 0.18 mg/l Potassium Hydroxide - 96 hr TLm 10 - 100 mg/1 Part B: Acetic Acid - 96 hr LC-50 (fathead minnow) >100 rog/1 Part C: None listed ~ 13. DISPOSAL CONSIDERATIONS Discharge, treatment, or disposal may be subject to certain government regulations. See Section 6 - Accidental Release Measures 14. TRANSPORTATION INFORMATION DOT: Not Regulated 15. REGULATORY INFORMATION Chemicals subject to the reporting requirements of Section 313 of Title 111 of the Superftmd Amendments and Reauthorization Act (SARA) of 1986 and 40 CFR Part 372: Hydroquin one, Diethylene Glycol 16. OTHER INFORMATION Prepared by: Engineering Dept. - Picker Iutemational, HCP, Cherry Hill, N.L', U.S.A. Phone Number: (609) 424-3620 Date: September 1996 PICKER INTERNATIONAL MATERIAL SAFETY DATA SHEET Issue Date September 1996 Catalog Number 256992 FOR EMERGENCY ASSISTANCE CALL CHEMTREC (800) 424-9300 (24 HOURS) · CHEMICAL PRODUCT AND COMPANY IDENTIFICATION SPECTRA Fixer & Replenisher Parts A, B & Working Solution ( 300 gallon size) Manufacturer/Supplier: PICKER INTERNATIONAL, Cherry Hill, NJ 08003 U.S.A, Phone (609) 424-3620 8:30 am - 5:00 pm EDT Monday - Friday 2. COMPOSITION/INFORMATION ON INGREDIENTS Ingredient %Weight/ CAS Reg. # ACGIH OSltA Target Volume TLV PEL Organ (s) Part A ***************************************************************************** Water 40 - 45 7732-18-5 .... None Listed Ammonium Thiosulfate 40 - 70 7783-18-8 .... Sodium Acetate 5 - 10 127'09-3 .... None Listed Sodium Bisulfite 4 - 8 7631-90-5 5 rog/m3 5 rog/m3 K,E,S Sodium Tetraborate 1 - 5 1303-96-4 1 rog/m3 10 mg/m3 E,S Water 60 - 70 7732-18-5 .... None Listed Aluminum Sulfate 40 - 45 10043-01-3 2 mg/m3 .2 rog/m3 E, R, S Citric Acid 1 - 5 77-92-9 .... T, S, E Acetic Acid 5 - 10 65-19-7 10 ppm 10 ppm R, S, E, T Working Solution******************************************************************** Water 80 - 90 7732-18-5 .... None Listed Ammonium Thiosulfate 10 - 15 7783-18-8 .... 'R, E Sodium Bisulfite 1 - 5 . 7631-90-5 .5 rog/m3 5 rog/m3 R, E, S Sodium Acetate 1 - 5 127-09-3 -- None LiSted Aluminum Sulfate. 1 - 5 10043-01-3 2 rog/m3 2 rog/m3 E, R, S TLV/PEL'S · C = Ceiling Value Target Organ (s): R = Respiratory System; S = Skin; E = Eyes; K -- Kidneys; T = Teeth C = Central Nervous System; L = Liver NONE OF THE ABOVE COMPONENTS ARE LISTED BY IARC, NTP OR OSHA AS A CARCINOGEN Page 1 of 5 SPECTRA Fixer & Replenisher Catalog NumbS56992 Issue Date: September 1996 Page 2 of 5 3. HAZARDS IDENTIFICATION Part A: Light yellow liquid with pungent odor (sulfur dioxide) that contains ammoniUm thiosulfate which produces ammonia in the presence of bases or high heat. HARMFUL IF SWALLOWED, CAUSES SKIN AND EYE IRRITATION AND 'MAY CAUSE ALLERGIC SKIN KEACTION. ' [lMIS [lazard Rating :Flammability - 0, Reactivity - 0, Health - 1, Protection - B Part B: Colorless liquid with pungent odor that contains acetic acid and aluminum sulfate HARMFUL IF SWALLOWED, MAY CAUSE EYE AND SKIN IRRITATION. ItMIS [lazard Rating:Flammability - 0, Reactivity - 0, Health - 1, Protection - B W:orking Solution: Pale Yellow liquid with characteristic fixer smell that contains sodium bisulfite. HARMFUL IF SWALLOWED, MAY CAUSE SKIN AND EYE IRRITATION. [IMIS Hazard Rating:Flammability - 0, Reactivity - 0, Health - 1, Protection - B 4. FIRST AID MEASURES Inhalation: Move to fresh air, obtain medical attention if required. Eye Contact: Hold eyelids apart and immediately flush eyes with plenty of water for 15 minutes. Get medical attention. Skin Contact:Immediately flush with plenty of water while removing contaminated clothing and shoes. Launder contaminated clothes and shoes prior to reuse. If skin irritation or an allergic skin reaction develops get medical attention. Ingestion: Part A: Induce vomiting as directed by medical.personnel. Never give anything by mouth to an unconscious person. Obtain medical care and hospital treatment immediately. Part B: hdt~c~)~miting as ~iir~d by medical personnel. Never give anything by mouth to an unconscious person. Obtain medical care and hospital treatment immediately. Working Solution:Drink 1 - 2 glasses of water, get medical attention. Fixer & Replenisher Catalog Number 256992 Issue Date: September 1996 Page 3 of 5 · FIRE FIGHTING MEASURES Extinguishing Media:Water spray, dry chemical, carbon dioxide (CO2) or alcohol foam.. Equipment: Wear seW-contained breathing apparatus and protective clothing to prevent contact with skin and eyes: Hazardous Combustion ProductsExcessive heat may produce haz'ardous decomposition products. Part A: Ammonia and oxides of sulfur. Part B: Oxides of sulfur. Working Solution:Ammonia and oxides of sulfur. Unusual Fire and Explosion HazardsNone Flash Points:None 6. ACCI])ENTAL RELEASE MEA~.URES Part A: Flush to sewer with large amount of water (pH 4.5 - 5.5). Part B: (pI-I 3.0 - 4.0 ) Neutralize with sodium bicarbonate, flush to sewer with large amount of water. Working Solution:Flush to sewer with large amount of water (pH 4.0 - 4.5). Otherwise, absorb spill with vermiculite or other suitable absorbent and place in impervious container for disposal ia aa approved and permitted landfill. Clean area thoroughly to remove residual contamination. 7. HANDLING AND STORAGE Avoid contact with eyes, skin and clothing. Store between 10 - 21i~ (50 - 80° F). Protect shipments from freezing (Keep above 4.°42 (40° F)) 8. EXPOS .URE CONTROLS/PERSONAL PROTECTION Engineering Controls Go6d-~'~//'eral venfil~i'~ii-( 10 room volumes per hour) should be sufficient to control airborne levels below recommended exposure limits when product is used as intended. Respirators: Should not be required. Eye Protection:Chemical splash goggles or face shield. Skin Protection:Impervious gloves (nitrile rubber). , ~TRA Fixer & Replenisher Catalog Number Issue Date: September 1996 Page 4 of 5 9. PHYSICAL AND CHEMICAL PROPERTIES Part A Part B Working Solution Physical State liquid liquid liquid Color ~. yellow colorless pale yellow Odor pungent pungent pungent Specific Gravity 1.4 1.3 1.1 pH 4.5 - 5.0 3.0- 4.0 4.0 ~ 4.5 Solubility in water complete complete complete Flash Point none none none Vapor density, vapor pressure, evaporation rate, boiling point and odor threshold levels not known. 10. STABILITY AND REACTIVITY Stability: All solutions stable under normal ambient and anticipated storage and handling conditions of temperature and pressure. ... Incompatibility: Part A: Strong oxidizing agents, acids and bases Part B: None. Working Solutions:Strong acids and bases Hazardous Decomposition Products: .. Part A: Sulfur dioxide and ammonia Part B: Sulfur dioxide Working Solution:Oxides of sulfur and ammonia Hazardous PolymerizationWill not occur with any solution. 11. TOXICOLOGICAL INFORMATION Eye effects Part A: Causes irritation Part B: Causes irritation Working Solution:Causes irritation Skin effects Part A: Causes irritation - May cause allergic skin reaction. Part B: Causes irritation Working Solution:Causes irritation - May cause allergic skin reaction. Fixer & Replenisher Catalog Number Issue Date: September 1996 Page 5 of 5 Oral effects: '~" Part A: Harmful if swallowed. May cause irritation of the gastrointestinal tract. Part B: Harmful if swallowed. May irritate the gastrointestinal tract. Working Solution:May cause irritation of the gastrointestinal tract. Inhalation effects-: Part A: Vapor irritating Part B: Vapor irritating Working Solution :Vapor irritating Chronic Effects:Part B contains acetic acid which may put persons who have chronic respiratory, s'kin or eye disease at an increased risk. 1.2. ECOLOGICAL INFORMATION Summary:These solutions have pH's (see Section 9) that may cause adverse environmental effects. Once neutralized 'and diluted these effects will be lessened substantially. Aquatic Toxicity: ~. Part A: Sodium bisulfite - 96 hr TLm (mosquito fish) fresh'water 240 ppm Part B: Aluminum sulfate - 96 hr TLm (mosquito fish) ? water 240 ppm 13. DISPOSAL CONSIDERATIONS Discharge, treatment, or disposal may be subject to certain government regulations. See Section 6 - Accidental Release Measures 14. TRANSPORTATION INFORMATION · DOT: Part A- Not Regulated .. "' Part B - Not Regulated 15. REGULATORY INFORMATION ............... Chemicals subject to the reporting requirements of Section 313 of Title 111 of the Superfund Amendments and Reauthorization Act (SARA) of 1986 and 40 CFR Part 372: None 16. OTHER INFORMATION Prepared by: Engineering Dept. - Picker International, HCP, Cherry Hill, N.J., U.S.A. Phone Number: (609)424-3620 Date: September 1996 THE ENCLOSED ARE PROCEDURES FOR REAL FIRE EMERGENCIES AS WELL AS FOR PRACTICE DRILLS FIRE DRILL PROCEDURES, RESPONSIBILITIES. ~ - discoverer must determine whether to extinguish or to close off area and, call operatorl WHO TO NOTIFY FIRST: decision to be based on situation and severity of fire. If coworkers are present- call out for help and give specific instructions. If alone- fight fire or call operator and give specific location and type of fire. HOW TO NOTIFY: Say "wastebasket fire in xray room 4", or "electrical fire in Mammo room B". This'will give operator terminology for calling PUBLIC ADDRESS ANNOUNCEMENT WORDING: "CODE RED IN XRAY~ROOM 4" ~- When danger has passed, announce: "Code Red Clear" RESPONSIBILITIES - use team approach - call those in immediate area BY NAME One person Calls operator, one gets fire extinguisher or starts patient evacuation. OPERATORS,SCHEDULERS Announce over PA, "CODE RED IN XRAY ROOM 4" . OperatorS/schedulers use team approach and verbally designate duties to each other. Additionally, you will assist in evacuating patients. Close conference,library, and scheduling office doors after cheCking for occupants. NURSE/TECHNOLOGISTS - Evacuate your areas of patients, visitors, and assist others. Turn off 02 and machine consoles, shut down CRT terminals, close doors after checking xray rooms, dressing and restrooms. 02 must be turned off .in: NucMed. stress room Specials Room · ' Nurse's Station CT,MRI DOCTORS - Assist in evacuation of immediate area, assist in pt handling and assessments, shut down CRT terminals and view boxes. CLERKS - second floor - Shut down CRT.s, close doors after checking kitchen, restrooms, offices, etc.. Assist patients and visitors. CLERKS - first floor - Assist in immediate areas and-with front lobby evacuation, check restrooms, close doors, shut down CRT.s. TRANSCRIPTIONISTS---"--Shut.ldown'-'machines,CRT.s, printers etc.. Assist patients, visit0~'~'~coworkers in immediate area. EXPEDITERS -. Assist in patient, visitor evacuation, check dressing areas, close doors. Wheelchairs may be needed from nurse's station. FILEROOM PERSONNEL - Check with and help in immediate area, assist in nurse's station, close area doors. ESCAPE ROUTES, OUTSIDE MEETING AREA - meet at WEST END OF PROPERTY near dumpsters. USE SAFEST, NEAREST EXIT. GENkRAL GUIDELINES: LEARN LOCATIONS OF FIRE EXTINGUISHERS Do not use elevator. Do not stop to take valuables. Stay calm, do not rush. BEFORE AND AFTER HOURS Call front desk to report type and location'of fire. Front desk personnel can then alert others AND call 911. Personnel who do not have patients in their areas must respond by going to aid those in fire area with fire extinguishers. REMEMBER -'these are guidelines for a real'fire too. For a fire drill simply mentally check off the responsibilities and duties. · KERN RADIOLOGY MEDICAL GROUP, INC. 2301 Bahamas Drive Bakersfield, CA 93309 (805) 322-1981 July 8, 1998 City of Bakersfield Fire Department Environmental Services 1715 Chester Ave. Bakersfield, CA 93301 Dear Mr. Huey, Please see the enclosed revised risk management plan for Kern Radiology Medical Group, Inc. The appropriate revisions and material safety data sheets are enclosed. If you have any questions please call me at (805) 322-1981 ext. 236. Thank you, D'Ln Brown Compliance Manager Enclosure Mailing Address: P.O. Box 2388- Bakersfield, CA 93303 - Fax No: (805) 324-1298 KERN RADIOLOGY & NUCLEAR MED 6 t~' ...... ~ SiteID: 215-000-000821 Manager : / // sPhone: (805) 322-1981 Location: 2301 BAHAMAS DR - / City : BAKERSFIELD ~ B~.,C M~ p : 102 CommHaz : Minimal ~.~ _2S~id: 26D FacUnits: 1AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:8011 EPA Numb: DunnBrad:77-025-1480 Emergency Contact / Title Emergency Contact / Title DONALD FITZGERALD / MD PRESIDENT ~ / BUSINESS MANAGE Business Phone: (805) 322-1981x Business Phone: (805) 322-1981x~ 24-Hour Phone : (805) 871-0664x 24-Hour Phone : (805) ~-~0-~9~r,~q~-~ Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Agency-Defined Topic Title ---- Hazmat Inventory One Unified List -- MCP+DailyMax Order Ail Materials at Site Hazmat Common Name... ISpecHazlEPA HazardsI Frm DailyMax IUnitlMcP DEVELOPER DH L 85 GAL Hi FIXER DH L 85 GAL Hi HELIUM F P IH G 405 FT3 Min 1 06/23/1997 KERN RADIOLOGY & NUCLEAR MED GP SiteID: 215-000-000821 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site DEVELOPER Days On Site 365 Location within this Facility Unit CAS# 1310-58-3 r STATE 1 TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Mixture Below Ambient Below Ambient PLASTIC CONTAINER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 85.00 85.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL %Wt. EHS CAS# 5.00 Potassium Hydroxide No 1310583 5.00 Diethylene Glycol No '1 111466 5.00 Hydroquinone (EPA) Yes 123319 1.00 1-Phenyl-3-pyrazolidinone No 92433 1.00 Glutaraldehyde No 110308 15.00 Acetic Acid, Anhydride No 108247 -2- 06/23/1997 KERN RADIOLOGY & NUCLEAR MED GP SiteID: 215-000-000821 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site FIXER Days On Site 365 Location within this Facility Unit CAS# 7783-43-3 V STATE -- TYPE i PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Mixture Below Ambient Below Ambient PLASTIC CONTAINER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 85.00 85.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL %Wt. EHS CAS# 15.00 Ammonium Thiosulfate No 7783188 1.00 Sodium Sulfite No 7757837 1.00 Acetic Acid, Anhydride No 108247 1.00 Aluminum Sulfate No 10043013 1.00 Sulfuric Acid (EPA) Yes 7664939 -3- 06/23/1997 KERN RADIOLOGY & NUCLEAR MED GP SiteID: 215-000-000821 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site HELIUM Days On Site 365 Location within this Facility Unit MRI/ISOLATED ROOM CAS# 7440-59-7 Gas Pure Above Ambient Ambient FIXED PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 405.00 405.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 HAZARDOUS COMPONENTS ! %Wt. I EHS CAS# 100.00I Helium No 7440597 -4- 06/23/1997 KERN RADIOLOGY & NUCLEAR MED GP SiteID: 215-000-000821 Fast Format = Notif./Evacuation/Medical Overall Site -- Agency Notification 03/11/1991 CALL 911 GENERAL ELECTRIC - 397-6144 ................. ~tO! j ~e-h ,~r-~cr-~--q- ~110-'" OFFICE OF EMERGENCY SERVICES - 800-852-7550 -- Employee Notif./Evacuation 03/11/1991 PUBLIC ADDRESS SYSTEM FIRE ALARM SYSTEM ALL EMPLOYEES TO EVACUATE BUILDING AT EXIT NEAREST THEIR LOCATION. GATHER AT NORTHWEST CORNER OF PARKING LOT FOR EMPLOYEE COUNT. -- Public Notif./Evacuation 03/11/1991 RECEPTIONISTS RESPONSIBLE FOR PATIENTS IN WAITING ROOM. EXPEDITORS RESPOSIBLE FOR PATIENTS IN DRESSING AREAS. TECHNOLOGISTS RESPONSIBLE OR PATIENTS IN EXAM ROOMS. Emergency Medical Plan 03/11/1991 PHYSICIAN ON PREMISES AT ALL TIMES DURING OPEN HOURS. FULL-TIME NURSE ON STAFF HALL AMBULANCE - 805-327-4111 GOLDENT EMPIRE - 805-327-9000 MEMORIAL OR MERCY HOSPITAL OR ER -5- 06/23/1997 ~ERN RADIOLOGY & NUCLEAR MED GP SiteID: 215-000-000821 Fast Format = Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 09/09/1992 HELIUM IS STORED IN SEPARATE ISOLATED ROOM. WASTE IS STORED IN RED AIR-TIGHT HAZARDOUS CONTITIONS PROCESSING CHEMICALS IN PLASTIC CONTAINERS SPRINKLER SYSTEM THROUGHOUT BUILDING SAFETY TRAINING MANUAL FOR EMPLOYEES -- Release Containment 09/09/1992 HAVE 50 LBS OF KITTY LITTER ON PREMISES AT ALL TIME. HAVE PERMANENT HAZARDOUS WASTE CONTAINMENT AND CLEAN UP KIT. -- Clean Up 09/09/1992 SP3REA}q, KITTY LITTER, USE SQUEEGEE AND DUST PAN. INSERT. IN HAZARDOUS WASTE CONTAINER. HAVE CONTRACT WITH HAZARDOUS WASTE DISPOSAL COMPANY, (SEQURiTY ENVIORL'?.ENT.~L. SYSTE.M~S) .TO REMOVE HAZARDOUS · I ~, ~; r~ Other Resource Activation 6 06/23/1997 KERN RADIOLOGY & NUCLEAR MED GP SiteID: 215-000-000821 Fast Format ~ Site Emergency Factors Overall Site -- Special Hazards 04/02/1993 RADIOISATOPES ON HAND - RADIATION HAZARD CONTAINERS ARE USED FOR ALL RADIOISOTOPES AND HAULED OFF SITE BY-SECUnITY ~-NViRONMENTAL ~Ji2[2- ~~ / ~1/~_/ ~_ ~ ~7~f~ -- Utility Shut-Offs 04/02/1993 A) GAS - SOUTHEAST CORNER OF BUILDING B) ELECTRICAL - SOUTHEAST CORNER OF BUILDING C) WATER - EAST SIDE OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 04/02/1993 PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM - FIRE EXTINGUISHER FIRE HYDRANT - NORTH SIDE OF BUILDING ON SOUTH SIDE OF STREET ADJACENT TO BUILDING Building Occupancy Level -7- 06/23/1997 f KERN RADIOLOGY & NUCLEAR MED GP SiteID: 215-000-000821 Fast Format ~ Training Overall Site -- Employee Training 03/11/1991 WE HAVE 50 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE AWARE OF: 1) LOCATION OF MATERIAL DATA SHEETS 2) USE OF FIRE EXTINGUISHERS 3) -- Page 2 Held for Future Use Held for Future Use I 8 06/23/1997 ]3~24/93 KERN ~DIOLOGY & ~CLEAR MED GP. ~215-000~00( 1ApR 1 199~a~ Overall Site with 1 Fac. Unit General Information By. I ' Location: 2301 BAHAMAS DR Map: 102 Hazard: Minimal ~Community: BAKERSFIELD STATION 01 Grid: 26D F/U: 1 AOV: 0.0 Contact..Name Title Business Phone--- 24-Hour Phone- DONALD FITZGE~LD MD PRESIDEN~: (805) 322-1981 x (805) 871-0664 BETTIE AZEVEDO ~.~.. BUSINESS MANAGER (805) 322-1981 x (805) 835-7679 Administrative Data Mail Addrs: .P O...BOX 2388 D&B Number: 77-025-1480 City: ,BAKERSFIELD State: CA Zip: 93309- Comm Code: 215~001 BAKERSFIELD STATION 01 SIC Code: Owner: KERN RADIOLOGY & ~CLEAR MED GP Phone: (805) 322-1981 i Address: P O BOX 2388 State: CA City: BAKERSFIELD Zip: 93309- , Summary : Do hereby certify that I have. RECEIVED reviewed the attached hazardous materials manage- merit plan for nd that it along with ~ ~ (Name~auen~sa) HAT. 1~4AT. DIV. any correctiOns constitute acornplete and correct man- agement plan f°r m~~ 03/24/93 KERN.RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Quantity MCP 02-001 DEVELOPER Liquid 85 High ~ Delay Hlth GAL 02-002 FIXER ~ Liquid 85 High ~ Delay Hlth GAL 02-003 HELIUM Gas 170 Minimal ~ Fire, Pressure, Immed Hlth FT3 03/24/93 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-001 DEVELOPER Liquid 85 High · Delay Hlth GAL CAS #: 1310-58-3 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GALI Daily Average GAL I Annual Amount GAL 85 ~ 85.00 85.00 Storage I Press T TempI Location PLASTIC CONTAINER IBelow ~Below~ I -- Conc Components MCP Guide 5.0% Potassium Hydroxide Moderate 60 5.0% Diethylene Glycol Low 27 5.0% Hydroquinone (EPA) Low 53 1.0% 1-Phenyl-3-Pyrazolidinone Low 1 1.0% Glutaraldehyde Moderate 58 15.0% Acetic Acid, Anhydride High 39 02-002 FIXER Liquid 85 High · Delay Hlth GAL CAS #: 7783-43-3 Trade Secret: No Form:.Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL I Daily Average GAL ,--~Annual Amount GAL -- 85 I 85.00__ 85.00 Storage I Press T Temp I Location PLASTIC CONTAINER IBelow /Below -- Conc I Components I MCP ---TGuide 15.0% Ammonium Thiosulfate Minimal I 31 1.0% Sodium Sulfite High ! 60 1.0% IAcetic Acid, Anhydride High ! 39 1.0% IAluminum Sulfate Low ! 31 1.0% ISulfUric Acid (EPA) High ! 39 03/24/93 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-003 HELIUM Gas 170 Minimal ~ Fire, Pressure, Imbed Hlth ~ ~,f~. /~.~_._~.. CAS #: 7440-59-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3 [ Daily Average FT3 [ Annual Amount. FT3 -- 170 [ 170.00 . 170.00 Storage Press T Temp Location FIXED PRESS. CYLINDER Above IAmbientI A4A~/3so~-~o~ /~ INSUL.TANK / CRYOGENIC AmbientICryogen - Conc Components MCP ---TGuide 100.0% IHelium IMinimal I 12 03/24/93 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 5 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 GENERAL ELECTRIC - 397-6144 SIERRA MEDICAL - 861-9729 OFFICE OF EMERGENCY SERVICES - 800-852-7550 <2> Employee Notif./Evacuation PUBLIC ADDRESS SYSTEM FIRE ALARM SYSTEM ALL EMPLOYEES TO EVACUATE BUILDING AT EXIT NEAREST THEIR LOCATION. GATHER AT NORTHWEST CORNER OF PARKING LOT FOR EMPLOYEE COUNT. <3> Public Notif./Evacuation RECEPTIONISTS RESPONSIBLE FOR PATIENTS IN WAITING ROOM. EXPEDITORS RESPOSIBLE FOR PATIENTS IN DRESSING AREAS. TECHNOLOGISTS RESPONSIBLE' OR PATIENTS IN EXAM ROOMS. <4> Emergency Medical Plan PHYSICIAN ON PREMISES AT ALL TIMES DURING OPEN HOURS. FULL-TIME NURSE ON 'STAFF HALL AMBULANCE - 805-327-4111 GOLDENT EMPIRE - 805-327-9000 MEMORIAL OR MERCY HOSPITAL OR ER 03/24/93 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 6 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention HELIUM IS STORED IN SEPARATE ISOLATED ROOM. WASTE IS STORED IN RED AIR-TIGHT HAZARDOUS CONTITIONS PROCESSING CHEMICALS IN PLASTIC CONTAINERS SPRINKLER SYSTEM THROUGHOUT BUILDING SAFETY TRAINING MANUAL FOR EMPLOYEES <2> Release Containment, HAVE 50 LBS OF KITTY .LITTER ON PREMISES AT ALL TIME. HAVE PERMANENT HAZARDOUS WASTE CONTAINMENT AND CLEAN UP KIT. / <3> Clean Up SPREAK KITTY LITTER, USE SQUEEGEE AND DUST PAN. INSERT IN HAZARDOUS WASTE CONTAINER. HAVE CONTRACT WITH HAZARDOUS WASTE DISPOSAL COMPANY, (SECURITY ENVIORNMENTAL SYSTEMS) TO REMOVE HAZARDOUS WASTE. <4> Other Resource Activation 03/24/93 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 7 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards RADIOISATOPES ON HAND RADIATION HAZARD CONTAINERS ARE USED FOR ALL RADIOISOTOPES AND HAULED OFF SITE BY SECURITY ENVIRONMENTAL <2> Utility Shut-Offs A) GAS - SOUTHEAST CORNER OF BUILDING B) ELECTRICAL - SOUTHEAST CORNER OF BUILDING C) WATER - EAST SIDE OF BUILDING D) SPECIAL - NONE E)~LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM - FIRE EXTINGUISHER FIRE HYDRANT - NORTH SIDE OF BUILDING ON SOUTH SIDE OF STREET ADJACENT TO BUILDING <4> Building Occupancy Level 03/24/93 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 8 00 - Overall Site <G> Training <1> Page 1 WE HAVE 50 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE AWARE OF: 1) LOCATION OF MATERIAL DATA SHEETS 2) USE OF FIRE EXTINGUISHERS 3) EVACUATION PLAN <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use KERN RADIOLOGY MEDICAL GROUP, INC. 230! Bahamas Drive Bakersfield, CA 93309 (805) 322-1981 March 19, 1993 Morgan Stuart 2101 H Street Bakersfield, CA 93301 Dear Mr. Stuart: Enclosed you will'~-r~d Hazma~ Inventory Detail in MCP Order. Sin ce re I.y,~'~'~ ~s Manager BA/cs Mailing ~4ddress: P.O. Box 2388- Bakersfield, C~4 93303 - Fax No: (805) 324-1298 02/~/93 , KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-001 DEVELOPER Liquid 85 .High · Delay Hith GAL CAS #: 1310-58-3 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL Daily Average GAL Annual Amount GAL Storage' Press T Temp Location PLASTIC CONTAINER [Below tBelow -~Conc .................. CD~D_o_nents .... MCP _G3ide 5,0% Potassium Hydroxide Moderate 60 5.0%. Diethylene Glycol Low 27 5.0% Hydroquinone (EPA) Low 53 1.0% 1-Phenyl-3-Pyrazolidinone Low 1 1.0% Glutaraldehyde Moderate 58 15.0% Acetic Acid, Anhydride ~ High 39 02-002 FIXER Liquid 85 High · Delay Hlth GAL CAS #: 7783-43-3 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL Daily Average GAL Annual Amount GAL Storage Press T Temp Location PLASTIC CONTAINER [Below [Below [ - ConcI Components - I MCP ---~G_ uide 15 0% ]Ammonium Thiosulfate-- ·, - ........ IMinimal -I 31 1.0% [Sodium Sulfite [High [ 60 1.0% [Acetic Acid, Anhydride [High ! 39 1.0% [Aluminum Sulfate [Low [ 31 1.0% [Sulfuric Acid (EPA) [High ! 39 02/02/93 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 4 '02 - Fixed Containers on Site ? Hazmat Inventory Detail in MCP Order 02'-003 HELIUM Gas 1.70 Minimal ) Fire, Pressure, Immed Hlth FT3 CAS #: 7440-59-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3 Daily Average FT3 Annual Amount-FT3 w Storage ~ Press T Temp ~ Location FIXED PRESS. CYLINDER IAbove ~Ambient INSUL.TANK / CRYOGENICIAmbient~Cryogen -- Conc Components MCP ---~uide' 100.0% I.Helium IMinimal I 12 07/29/92 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 1 Overall Site with 1 Fac. Unit General Information Location: 2301 BAHAMAS DR Map: 102 Hazard: Minimal Community: BAKERSFIELD STATION 01 Grid: 26D F/U: 1 AOV: 0.0 Contact Name Title Business Phone -- 24-Hour phone- DONALD FITZGERALD MD PRESIDENT (805) 322'1981 x (805) 871-0664 BETTIE AZEVEDO BUSINESS MANAGER (805) 322-1981 x (805) 835-7679 ~Administrative Data Mail Addrs: P O BOX 2388 D&B Number: 77-025-1480 City: BAKERSFIELD ~ State: CA Zip: 93309- Comm Code: 215-001 BAKERSFIELD STATION 01 SIC Code: Owner: KERN RADIOLOGY & NUCLEAR MED GP Phone: (805) 322-1981 Address: P O BOX 2388 State: CA City: BAKERSFIELD Zip: 93309- Summary RECEIVED SEP 0 8 1992, HA7. ~aT. _Berrie Azevedo Do hereby certify that I have L (Type m, pdnt frame) reviewed the attached haza~Jc, u~ materials manage. merit plan for Z~ern Rad~o_!L~y' arid that it along with any comection$ cons~tute a complate and corre~ man- ageme~ plan fl;r my fa~li~. 9/3/92 07/29/92 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 DEVELOPER Liquid 85 High . ~ Delay Hlth GAL CAS 9:1310-58-3 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS -- Daily Max GAL85. I . Daily Average 85.00 GAL ,--~ Annual Amount 85.00 GAL Location Storage Press T Temp PLAStiC IBelow /Below -- Conc Components MCP -List 5.0% Potassium Hydroxide Moderate 5.0% Diethylene Glycol Low 5.0% Hydroquinone (EPA) Low EPA 1.0% 1-Phenyl-3-Pyrazolidinone Low 1.0% Glutaraldehyde Moderate 15.0% Acetic Acid, Anhydride High 02-002 FIXER Liquid 8'5 High ~ Delay Hlth GAL 'CAS #: 778'3-43-3 Trade Secret: No Form: LiqUid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL85 I Daily Average85.00GAL Storage ~. Press T Temp Location PLASTIC CONTAINER IBelow /Below _ - Conc Components , MCP {List 15.0% IAmmonium Thiosulfate IMinimal 1.0% ISodium Sulfite IHigh 1.0% IAcetic Acid, Anhydride IHigh 1.0% ~Aluminum Sulfate ~Low 1.0% '[Sulfuric Acid (EPA) ~High {EPA 07/29/92 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-003 HELIUM Gas 170 Minimal ~ Fire, Pressure, Immed Hlth FT3 CAS #: 7440-59-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3'170 I Daily Average170.00FT3 I Annual Amount170.00~FT3 ~torage Press T Temp ~ Location FIXED PRESS. CYLINDER IAbove I Ambient INSUL.TANK / CRYOGENICIAmbient~Cryogen -- Conc Components MCP List 100.0% IHelium Minimal I 07/29/92 KERN RADIOLOGY .& NUCLEAR MED'GP 215-000-000821 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 GENERAL ELECTRIC - 397-6144 SIERRA MEDICAL - 861-9729 OFFICE OF EMERGENCY SERVICES - 800-852-7550 <2> EmPloyee Notif./Evacuation PUBLIC ADDRESS SYSTEM FIRE ALARM SYSTEM ALL EMPLOYEES TO EVACUATE BUILDING AT EXIT NEAREST THEIR LOCATION. GATHER AT NORTHWEST CORNER OF PARK'ING LOT FOR EMPLOYEE COUNT. <3> Public Notif./Evacuation RECEPTIONISTS RESPONSIBLE FOR PATIENTS IN WAITING ROOM. EXPEDITORS RESPOSIBLE FOR PATIENTS IN DRESSING AREAS. TECHNOLOGISTS RESPONSIBLE OR PATIENTS IN EXAM ROOMS. <4> Emergency Medical Plan PHYSICIAN ON PREMISES AT ALL TIMES DURING OPEN HOURS. FULL-TIME NURSE ON STAFF HALL AMBULANCE - 805-327-4111 GOLDENT EMPIRE - 805-327-9000 MEMORIAL OR MERCY HOSPITAL OR ER 07/29/92 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 5 00 - Overall Site' <E> Mitigation/Prevent/Abatemt <1> ReleaSe Prevention HELIUM IS STORED IN SEPARATE ISOLATED ROOM. WASTE IS STORED IN RED AIR-TIGHT HAZARDOUS CONTITIONS PROCESSING CHEMICALS IN PLASTIC CONTAINERS SPRINKLER SYSTEM THROUGHOUT BUILDING Safety training manual for employees <2> Release Containment HAVE 50 LBS OF KITTY LITTER ON PREMISES AT ALL TIME. Have permanent hazardous waste containment and clean up kit. <3> Clean Up squeegee SPREAK KITTy. LITTER, USE ~2~ AND DUST PAN INSERTPIN HAZARDOUS WASTE CONTAINER. HAVE CONTRACT WITH HAZARDOUS WASTE DISPOSAL COMPANY, (SECURITY ENVIORNMENTAL SYSTEMS) TO REMOVE HAZARDOUS WASTE. <4> Other Resource ACtivation 07/29/92 KERN RADIOLOGY & NUCLEAR MED GP 215-000-00082,1 Page 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards RADIOISATOPES ON HAND RADIATION HAZARD Containers are used for all radioisotopes_and hauled off site:by Security Environmental. <2>.Utility Shut-Offs A) GAS - SOUTHEAST CORNER OF BUILDING B) ELECTRICAL - SOUTHEAST CORNER OF BUILDING C) WATER - EAST SIDE OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM - FIRE EXTINGUISHER FIRE HYDRANT - NORTH SIDE OF BUILDING ON SOUTH SIDE OF STREET ADJACENT TO BUILDING <4> Building Occupancy Level 07/29/92 KERN RADIOLOGY & NUCLEAR MED GP 215-000-000821 Page 7 00 - Overall Site <G> Training <1> Page 1 WE HAVE 50 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE AWARE OF: 1) LOCATION OF MATERIAL DATA SHEETS 2) USE OF FIRE EXTINGUISHERS 3) EVACUATION PLAN <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use Bakersfield Fire Dept. Hazardous Materials Division 2130. "G" Street Bakersfield, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN llq$?RU¢?lON$: ~ ~-~::~0 2. TYPE/PRINT ANSWERS iN ENGLISH. 3. Answer tge questions below for the business os o wl~ole. 4. Be Drier oncl concise os possiDle. SECTION 1: BUSINESS IDENTIFICA~ON DATA BUSINESS NAME: Kern Radiology Medical Group, Inc. 2301 Bahamas Drive LOCATION: MAILING ADDRESS: P.o. Box 2388 93303 CITY: Bakersfield STATE: ' CA ZIP: 93309 PHONE: (805) 322-1951 DUN A BRADSTREET NUMBER: 77-0'251480 SiC CODE: PRIMARY ACTIVITY: XlRay office OWNER: Kern Radiology Medical Group, Inc. MAILING ADDRESS: P.o. Box 2388, 'Bakersfieldr CA 93303 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Donald T.. Fitzgerald, M.D. Pres. 322-1981 871-9664 Bettie Azevedo, Business Manager 322-1981 835-7679 2. FD150 Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYESS' 50 MATERIAL SAFETY'DATA sHEETS ON FILE: Attached BRIEF SUMMARY OF. TRAINING PROGRAM' All employees are aware of: 1. Location Material Data Sheets 2. Use of Fire Extinguishers 3. Evacuation Plan SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE 'DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM' REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, ~ 7-7~/~~_ . _ _ ~/~;:~ ~ CERTIFY THAT THE ABOVE INFOR- MAT~O~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 FD159,~ Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: Kern Radiology Medical Group, Inc. SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A.. AGENCY NOTIFICATION PROCEDURES: Fire Dept. - 911 (has on-site traini.ng of ~4RI unit) General Electric - (805/) 397-6144 (Equipment vendor) Sierra Medical - (805) 861-9729 · (Processor Chemicals). OES (80..) ~,5~.-7.~50 B. EMPLOYEE NOTIFICATION AND EVACUATION: Public Address System Fire Alarm System Ail employees to evacuate building at exit nearest their location. Gather at NW Corner of parking lot for employee count. C. PUBLIC EVACUATION: Receptionists responsible for patients in Waiting Room. Expeditors responsible for patients in dressing areas. Technologists responsible for patients in exam rooms. D. EMERGENCY MEDICAL PLAN: Physician on premises at all times during open ho~rs. Full-time nurse on staff Hall Ambulance -'(805)327-4111 ,' Golden Empire - (805)323-9000. Memorial or Mercy-Hospital for'ER . Bakersfield Fh:e Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: Helium~:'~)is stored in separate isolated room Waste ~"~tored in red air-tight hazardous containers Processing chemicals in plastic containers Sprinkler system throughout building B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Have 50 lbs. of Kitty litter on premises at all times. C. CLEAN-UP PROCEDURES: Spread kitty litter, use broom and dust pan Insert in hazardous waste container. Have contract with hazardous waste disposal company (Security Environ. Systems) to remove hazardous waste. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)' NATURAL GAS/PROPANE: SE corner of building ELECTRICAL: sE corner of building East side of building WATER' SPECIAL: LOCK BOX: YES IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: ,Sprinkler system - Fire Extinguisher WATER AVAILABILITY (FIRE HYDRANT)' Located on north side' of building on south side of street adjacent to building. 4. CITY of BAKERSFIELD Farm and Agriculture ~ Standard Business''j~HAZARDOUS MATERIALS INVENTORY ~ NON--TRADE SECRETS Page 2 of2- BUSINESS NAHE: KEI:~N ~T:LADIOZDGY - OWNER NAME: NAME 0F THIS FACILITY: ~ ~IO~ ~9~6TIQ~i 23,0i ~s' Drive ADDRESS: STANDARD IND CLASS COO~' ~;.!~.~ ~: ~rRf~ld~ PA 9qq~q ~[~ lIP:_ DUN AND BRAD~TREET NUMBER FHUmb ~: (RDq) q99-1Q~l -- VHUN~ ~: - - '.- ' .... ~ .REFER TO~N~~UNS PU~ ~HOP~ CO~ES -- Na~es of ~ixture/Co~onenCs · ~r~ns lyre ,ax Average Annual ~easure ISJ~YSe Con~ ~on~ Con~ Us Loc{~ion.~he(e. Code ~oae AaL Aa~ ~s~ Units on lype.. . Press lemp Coue S~orea I~ ~acl/i~y See lnsLruc~onS Physical and Heai%h Hazard C.A.S. Number Componen~ I1 ~a~e t C.~.S. Number 1310-53-3 L-5 Potassi~ Hy~de (Check all ~ha~ ap~ly) Fire Hazard ~ Reactivi[y ~ Belayed ~ Sudden Release ~ Immediate Componen[ 12 Name t C,A,S. Number 111-46-6 L-5 Diethylene Giy~i : ~ Realth of PressureHealth Component ~3 Name J ~.A,S, Number 123-31-9 _-5 Hyd~one Physical and Heal[h Hazard C.A.S. Number Componen~ I1 Name I C.A.S. Number 92-43-3 1-1 1-Phenyl-3-~azolidone (Check all that apply) Component 12 Name & C.A.S. Number 111-30-3 ~-1 ~ Fire Hazard ~ Reactivity, D Delayed D Sudden Release ~ Im~i~ Hem ICh of Pressure Component 13-Name & C.A.S, Number64-[9-7 [)?[ ~e[~c Physical and Health Hazard C.A.S. NH=bar Component 11 ~e I C.A.S. Number7783-18-8 L0- .5 ~ni~ ~iosulfate (Check ali th~ Componen~ J2 Name ~ C.A.S. Number 7757-83-7 ,-1 ~ Sulfite B Fire Hazard B Reactivity B Delayed B Sudden Release B Hem lth of Pressure Health Component 13 Name & C.A.S. Number64-19-7 -1 ~etic Physical mhd Health Uaiard C.A,S, Number Component I1 Name I C.A,S, Numberlo043-91-3 0-: ~~ Sulfate ~ (~heck a)) that apply) Component 12 Name ~ C.A,S. Number7664-93-9 9-~ Sulf~ic ~id ~ Fire Hazard ~ Reactivity ~ Oelayed ~ Sudden Release ~ Xm~9di~e ' Health of Pressure Healt~ : Component 13 Name ~ C.A,S, Number EMERGENCY CONTACTS ~i~b ~1~ Safety Officer (805) 322-1981 #2 ~e A~vP~n ~ss ~.~nager (805) 322-~981 ~me Tlt)e Z4 ,r Phone Naae ))~one eertwy unoer penmm~) o;)~) tnq: ~navepersonmlm),examlnqo~Qo)m ~amimla[~it~ the iniorma~ion ~ubaittgd iuthis.~nd al) ~ ~ attached documents, anQ t~m~ oaseo on.ay inquir) g.~nose )nOlV)Oua(s respons)~/e tot ob~a)nin~ the ln;orma~io~I belJevet~/ ~ submitted information is true, accurate, and complete, ~.~d'~fi~i~le of o,netlo~,rator o~ o,~erloper~to~ {'muthbrized rebresen~a~iV, ~ ~~/ ' CITY ,of, BAKERSFI ELD ~ HAZARDOUS MATERIALS INVENTORY Farm and Agriculture 1'] Standard 6usiness ~] '.,~,.-. ~". NON--TRADE SECRETS Page BUSINESS NAHE:KERN' PJ~DIOLOGY OWNER NAME: NAME OF THIS FACILITY:KE:R.N ~Lg.C,A, TIQ.Ni ,2.3Pt uanamas Drive ADDRESS; - STANDARD IND. CLASS CODE: uz/Y. tlr: ~tl~ersz:le±d, CA. 93309 CITY. ZIP: DUN AND BRA~S]EREE,] I~UI~ER~ PHONE Il: (RD:;) 32:2-19R1 /;PHONE ti: - - -uo o ~ :., J- 3 9 8 . rEFER. TO--IN~TRUUT'IONS-'FOR--PROPER CODES --- -' ' ~ i,ranScode coo,!Y IN Ami;Max AverpgeAmc AnnualEst Neas.Ureun,cs on' tI~e ContType ' Press~°nt ContTemp UScoleStoredL°Cat'i"°n?e[e',n Pacll,U ~a~y NameSseeOf' Id xture/¢omponentSlnstruct,ons .M. INATE/ ft I 365 7 , 2'7 , 1.~%HELIUM L.IOUID~ PhySical and ~ea)thHazard ¢.A.S. Number 7,a~0-.59-7 Component I~ Name & C.A.S. Number {Check all that apply) Component 12 Name I C,A.S. Number I Fire Hazard I-! Reactivity [] Delayed '~ Sudden Release ~ Immediate Health of Pressure Health Component 13 Name I C.A.S. Number Physical and Pealth Ualard C.A.S, Number ~ ComponenL II Name I C.A,S. Number State 6f California (Check al/ that app/yJ . ~adioactive }4aterials ~ ~0mponent 12 Hame ~ C.A.S. Number :icense 92012-25 · Health of Pressure .. Componen: 13 Name I C,A,S, Number · lead containers ~'- Physical and Health UaIard C,A.S, Number ?aad-sq-7 ', . Component II Name I C,A,S, Number 10 3%HELIUM GAS ,~ ICheck a)l that APp/D { ,, CQmponenk 12 Name I C,A,5. Number k- ~ Fire Hazard ~ Reactivity ~ 0elayed ~ Sudden Release ~ 'm~'~ .... Health of Pressure Component 13 Name I C.A.S. Number rPhvskal and Health Ualard C,A,S, Number Component II Na~e I C,A,S, Number .- . "(Check 411 that app/yl " '% Component 12 Name I C,A.S. Number .~'.- ~ Fife'Hazard ~ ReacLiyitr ~ Delayed ~ Sudden Release ~ le~i~ ' -- ': '~ Health of Pressure ~ Component 13 Name I C,A,S. Number ": ' .~ .,.. , .:.- ~,EHERGEHCY ~ONTACTS ¢1 , Hame ' , Title 24.'hr Phone" Rame Tltle '~ertifi~aLioq ' .(Re~d and.~fgn after c~mpT~Cfpg.al7 sectional ,.~er[~t~ uAoer pena~t~ W)a~ thqt J flavepe~sonaj~y, examin~ggqo Om tamillaLviththe intoEmatlOn Submitted in this. Qnd at*acfled d~cumeots, lng Trial oaseo on.my Inquiry ~r.tnose inoivloul/s responsible for obtaining the Information. [ believe that the submitted ~nformatlon IS true, accurate, ano complete, , ,e,e e~d oriciai [1('la of o~ner/operator oH o~fler/Operator's authotfzed representative Signature OaT~N~ .... BAKERSFIELD FIRE DEPARTMENT BUREAU OF FIRE PREVENTION APPLICATION Application No. In conformity with provisions of pertinent ordinances, codes and/or regulations, application is made by: , Name of to display, store, install, use, o~rate, sell or handle materials or pr~esses involving or creating con- ditions deemed hazardous to life or pro~r~ as follows: Authorized Repre~nt~dve /-- ,~/~, .................../,;~ , ~r~~ ...... ~...~.~ ...... ~ ........................ ,~.'-~..~.~ ...................................................... ./'g , .~ Fire Mam~l v'' ERSFIELD crr F RE D A ~i3o "G" STREET RECEIVED OFFICIAL USE ONLY INS~U~IONS: 1. To avoid fu~heF act/on, ~etu~n this fo~m by A. ~E/PRINT ~SWERS IN ENGLISH. 3. Answe~ ~he questions below fo~ the business as a ~hole. 4. Be as b=ief ~d concise as 9ossible. S~ION 1: BUSI~SS ID~IYICATION DATA A. BUSI~SS N~: Kern Radiology and Nuclear Medical Group, Inc. B. LOCATION / STREET ADDRESS: 2807 H Street CI~: Bakersfiel~ ZIP: 93301 BUS.PHON~: (805) 322-1981 SECTION 2: EMERGENCY NOTIFICATIONS In c~se of an emergency involvin~ the release or threatened release of a hazardous material, call 911 and 1-800-852-T550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. _ EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: N~E AND TITLE DDqllNG BUS. HRS. AFTER BUS. HRS. A. Bob Balow Ph~ 872-2802 Ph~ 832-7192 8. Bettie Azevedo Ph~ 872-280'2 Ph~ 871-7817 SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A W~OLE A. NAT.~ROPANE: Outside back building B. ELECTRICAL:~ Outside back building C. WATER: Outside back building D. SPECIAL: Outside back building LOCK BOX: YES ?~_~ IF YES, LOCATION: E. IF YES, DOES IT CONTAIN SITE PLANS? YES / NO ~SDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO SECTION;i~ PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE All technologists and personnel are aware of Fire Extinguisher locations and exits. Each technologist is instructed to see their patient exits building and clerical personnel instructed to see all patients in waiting room are evacuated. SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTM~CE FOR YOUR BUSINESS AS A WHOLE Willard Christiansen, M.D. 2021 22nd Street Bakersfield, CA 93301 (805)327-9617 SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGR3%M WHICH PROVIDES EMPLOYEES WITH I~NITI'AL REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES 0R NO I,%'ITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS ~ ,MATER IALS: . . .' ................................... NO NO PROCEDURES FOR COORDINATING ACTIVITIES B. WITH'RESPONSE AGENCIES: .......................... ~. NO ~~0 C. PROPE.R USE OF SAFETY EQUIPMENT: .................. <i~ NO ~..NO D. EMERG:NCY EVACUATION PROCEDURES: ................. ~~NO C~-Y-ES .~O E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES~_~ YES NO DOES YOUR BUSINESS HANDLE HAZARDOUS .~qTERIAL IN QUANTITIES LESS THAN ~00 POL~DS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES NO I, Bettie Azevedo , certify that the above information is accurate.' I understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 8.95 Sec. 28500 Et Al.) and that inaccurate information constitutes perjury. SIJ~ TITLE Business Manager DATE ~/~/~.,. / - 2B -