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Home My WebLink AboutBUSINESS PLAN 8/13/2003 Hazardous. Materials/Hazardous Waste Unified Permit CO, NDITIONSOFP N REVERSE SIDE ' · ~ '.. ~BAKERSFIEL~ ~ ~D.FAMILY MED'. '- 'LOCATION: 4580 CALl ORNIAAVE 312 ~ i.' '" Bakersfield, CA 93301 ~ ,~. - . OmceofEv~2 Voice (661) 326-3979 .. ':,~::,~'ExP~tionDate: BAKERSFIELD FAMILy MEDICAL CENTER SAFETY MANU~ Marie Pet~rson, Safety~ctor.., ' Approved By: ~~-~::~/" ~ . Date: Mary Ing(~ff, Ass')~iate V.P., Clinical Services WATER - ~ YOU ~ A LOCK SOX FI~ ~~ Lo~TED 'B~K~s~IELD FAMILY ME ENTER ~ _ SiteID:'015_021~001480 · "-k p ~.~ '/~'~Wl.t o/~. Manager : t~h=I-b-~ ...... '~H-~5~F~D~ uFFi~,~ BusPhone: (661) 327-4411 Location: 4580 CALIFO~IA AVE 312 Map : 102 Com~az : Minimal City : BAKERSFIELD Grid: 35A FacUnits: 1 AOV: CommCode: B~KERS~IEBD STATION 03 SIC Code:801I EP~ ~u~: C~836~7044 DunnBrad: 'Emergency Contact / Title ~mergency Contac~ / Title ~-~L~I~ ~ / SAFETY DIRECTOR DEBO~ HOLMES / X-~Y TECH Business Phone: (661) 846-4639x Business Phone: (661) 327-4411x4827 24-Hour Phone : (661). 327-4411x 24-Hour Phone : ( ) - x Pager Phone : (661) ~S2~6215x Pager Phone : ( ) - x Hazmat Hazards: Fire Press React .Im~lth DelHlth Contact : F~K ARMIJO Phone: (661) 321-0981x MailAddr: 4580~ CALIFO~IA AVE 312 State: CA City : BAKERSFIELD Zip : 93309 Owner RIC~RD MERKIN MD Phone: (661) 327-4411x Address : 4580 CALIFORNIA AVE 312 State: CA City : BAKERSFIELD .Zip : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~-,~ ,rTL · 0 hereby certify that I have (Tv~ of' I:~nt name) reviewed the attached hazardous materials manage- -'~'~¢:~&,~ '~,~',/¥ ment plan' forlq~A ;o~ ~mLdr-and that it along With (Name el Bu~lne~=) , any COrrections COnstitute a complete and correct man- agement plan ~or my facility. Signature Date -1- 07/02/200.3 f B~KERSFIELD FAMILY ME ENTER SiteID: 015-021-001480 ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within th'is Facility Unit Map: Grid: SE CORNER 1ST FLOOR CAS# 7782-44-7 F STATE -- TYPE PRESSURE~ TEMPERATURE CONTAINER TYPE Pure Above Ambient I Ambient PORT. Gas . PRESS CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 25.00 FT3 I 1200.00 FT~ 1200.00 FT3 HAZARDOUS COMPONENTS %Wt. I RSI cas# 100.00 Oxygen, Compressed No 7782447 HAZARD ASSESSMENTS TSecret IN~SNo Bi°HasINO Radioactive/AmountNo/ Curies EPAF Hazards I NFPAIH DH / / / USDOT# MCP MISC. LOCAL AGENCY DATA Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag. Defined4: Ag. Defined5: Ag.Defined6: Ag. Defined7: Ag.DefinedS: Ag.Definedg: Ag.Definel0: -- Ag. Definell BAKERSFIELD FAMILY MED CENTER SiteID: 015-021-001480~'9 ~ !'nventory Item 0001 Facility Unit: Fixed, Containers at Site -- COMMON NAME / CHEMICAL NAME 'LIQUID NITROGEN' Days On Site 365 Location within this Facility unit Map: Grid: NE & SE COMER 2ND FLOOR .CAS# 7727-37-9 Gas /Pure ~ove A~ient Cryogenic INSUL.TANK / CRYOGENIC I IAMO~TS AT THIS LOCATION Largest Container Daily Maximum Daily Average 251.00 FT3 502.00 FT3 502.00 FT3 ~ZARDOUS COMPONENTS 100.00 Nitrogen 7727379 iTSecret RS BioHaz ~ZARD ASSESSMENTS I I Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min MISC. LOCAL AGENCY DATA Ag. Definedl: ,. Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5:' Ag. Defined6: Ag. Defined7: Ag.Defined8: Ag.Definedg: Ag. Definel0: -- Ag.Definell 4 0?/02/2003 F BAKERSFIELD FMILY MED CENTER SiteID: 015~021-001480 ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site --,,COMMON NME / CHEMICAL NME WASTE FIXER Days On Site PHOTOG~PHIC FIXER 365 Location within this Facility Unit Map: Grid: Liquid Waste A~ient A~ient P~STIC CONTAINER I MO~TS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 30.00 GAL %Wt. S CAS# Silver N 7440224 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies R / / / ~Min MISC. LOCAL AGENCY DATA Ag.Definedl: Ag.Defined2: Ag. Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.DefinedT: ~.DefinedS: ~.Definedg: Ag. Definel0: -- Ag.Definell ~5- 07/02/2003 BAKERSFIELD FAMILY ME ENTER SiteID: 015-021-001480 . .'Fast Format ~ ,Notif./Evacuation/Medical Overall Site -,- Agency Notification :. ~ 04/03/2000 -- Employee Notif./Evacuation 04/03/2000 OVERHEAD PAGING SYSTEM. Public Notif./Evacuation 04/03/2000 PUBLIC ADDRESS SYSTEM VIA TELEVISION AND RADIO. Emergency Medical Plan 04/03/2000 BAKERSFIELD FAMILY MEDICAL CENTER, URGENT CARE OR SAN JOAQUIN HOSPITAL. 7 07/02/2003 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r'~ Floor, Bakersfield, CA 93301 FACILITYNAlylE~gC, O.O ~t~60.6C0-~ INSPECTION DATE ~'/Z$/o'2.. ADDRESS '~5'T~ ~ax~ r-~t~ ~ PHONE NO. 3'Z? - ~-'/- FACILITY CONTACT r~.~¢~. $~'r~'~-- BUSINESS ID NO. I$-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~ Routine [~ombined ~l Joint Agency ~ Multi-Agency ~.~ Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand ~ I "~'~"~'~ b t~_ Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities r.a~_,'~-O E,~:L ~' ~._c,_~ Verification of location ~'-,,A- C./V'c~ g '~"~o0 Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers proPerly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?:Explain: ')(- ~ ~,-/-O~ [~-Yes [=]No Questions regarding'this inspection? Please call us at (661) 326-3979 Business Sit esp~sible Party White - Env. Svcs. Yellow - Station Copy Pink- Business Copy Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME O~s.c,c.-~ ~mn, t, cg~' ~6b. ~ INSPECTION DATE Section 4: Hazardous Waste Generator Program EPA ID # ~ [] Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made /~'t c.~/~'~ ~'x-cty) EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) ~ I n'l:5-~ ~ ~ Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kep~ closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels -Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal C=Compliance V=Violation d~,,~,×.. ~~/~_A/~ Inspector: /~ t ~'fl ' Bu'sifies e 'l~c~s'ponsib~-e 3arty Office of Environmental services (661) 326-3979 White - Env. Svcs. Pink - Business Copy BAKERSFIE~ ,FAMILY MED CENTER ~ .... I SiteID: 215-000-001480 ....... , - - -- ~ IVI/tW~ 8 Z~O , · 1.-,~ · Location: 4580 CALIFORNIA AVE 3~1,2'~A_ ~_.~. °ne' CommHaz : Minimal City : BAKERSFIELD '=~-v/'-Gr~: FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 03 SIC Code: 8011 EPA Numb: CAD983617044 DunnBrad: Emergency Contact / Title Emergency Contact / Title MARIE PETERSON / SAFETY DIRECTOR .DEBORAH HOLMES / X-RAY TECH Business Phone: (661) 846-4639x Business Phone: (661)~ -~{~x~ 24-Hour Phone : (~1)~ ~q'~ x 24-Hour Phone : (~%~)~ -~Jl x~ Pager Phone : (~.~!)~'~5 '~l~-x Pager Phone : ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact :~V9%~'~ ~i?~'\~O Phone: (&~{{)~a~ -0~i x MailAddr: 4580 CALIFORNIA AVE 312 State: CA City : BAKERSFIELD ,~ Zip : 93309 Owner -~EDaN=.W~RK %'%C~O~ ~,f'~.~ ~'~ Phone: (805) 327-4411x Address : 4580 CALIFORNIA AVE 312 ~ State: CA City : BAKERSFIELD i Zip : 93309 Period : ~[1~,~5' ~ to ~l/~/O, TotalASTs: = Gal Preparer: ~S'~ ~.~f-- ~ TotalUSTs: = Gal Certif'd:~6~C~% ~\i~ % ~.~ [c~9~c5~ RSs: No Emergency Directives: LIST TW~MERGENCY CONTACTS. I _ l~.~_~,~/-2· Z/,~,z/~>.~ Do hereby cerU~y thai ~ have (Type or pfin! name) "" reviewed the attached hazardous materials manage- - rnent plan forzi~/~-./~;.~ ~.~, ,~,~and that it along with (Name of Business) any corrections constitute a complete and correct man- agement plan for my faciliiy. 1 02/28/2000 B~ERSFIELD F~ILY MED CENTER SiteID: 215-000-001480 ~ Hazmat Inventory By Facility Unit ~ Alphabetical Order Fixed Containers at Site Hazmat Common Name... ISpecHazIEPA HazardsI Frm I DailyMax IUnit MCP LIQUID NITROGEN F P IH G 502.00 FT3 Min OXYGEN F IH DH G 500.00 FT3 Low WASTE FIXER R L 60.00 GM Min 2 02/28/2000 BAKERSFIELD FAMILY MED CENTER SiteID: 215-000-001480 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME LIQUID NITROGEN Days On Site 365 Location within this Facility Unit Map: Grid: NE & SE CORNER 2ND FLOOR CAS# 7727-37-9 Gas Pure Above Ambient Cryogenic INSUL.TANK / CRYOGENIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 251.00 FT3 502.00 FT3 502.00 FT3 HAZARDOUS COMPONENTS %Wt. ~S CAS# 100.00 Nitrogen N 7727379 HAZARD ASSESSMENTS TSecretl ~S BioHazl Radioactive/Amount EPA HazardsI NFPA USDOT# MCP No N No No/ Curies F P IH / / / Min ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: SE CORNER 1ST FLOOR CAS# 7782-44-7 rSTATE i TYPE PRESSURE ~ TEMPERATURE - CONTAINER TYPE Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 25.00 PT3I 500.00 FT3 500.00 ET3 HAZARDOUS COMPONENTS %Wt. Oxygen, ~S CAS# 100.00 Compressed N 7782447 HAZARD ASSESSMENTS ' ,,TSecretI RSIBioHaz, Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -3- 02/28/2000 BAKERSFIELD FAMILY MED CENTER SiteID: 215-000-001480 ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~tvUVl~ ~Vl~ / ~1 ~.-~.1.~ ~vl~ WASTE FIXER Days On Site PHOTOGRAPHIC FIXER 365 Location within this Facility Unit Map: Grid: CAS# ~ STATE ~ TYPE i PRESSURE TEMPERATURE I CONTAINER TYPE Liquid /Waste Ambient Ambient PLASTIC CONTAINER AMOLTNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average 30.00 GAL{ 60.00 GAL{ 30.00 GAL HAZARDOUS COMPONENTS Silver N 7440224 HAZARD A~SESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCP No N° No No/ Curies R / / /I Min -4- 02/28/2000 F BAKERSFIELD FAMILY MED CENTER SiteID: 215-000-001480 Fast Format ~ Notif./Evacuation/Medical Overall Site -- Agency Notification ,~ , 02/22/2000 WHAT AGENCIES WOULD YOU NOTIFY I~CASE OF A HAZARDOUS MATERIAL~_INCIDENT???? 02/22/2000 iEmployee Notif./Evacuation HOW WO~D YOU NOTIFY YO~ EMPLOYEES TO EVACUATE??????? -- Public Notif./Evacuat~on 02/22/2000 HOW WOULD YOU NOTIFY THE P~LIC TO EVACUATE?????? Emergency Medical Plan 02/22/2000 ~T MEDIC~ FACILITY WO~D YOU USE IN CASE OF ~ EMERGENCY???????? -5- 02/28/2000 BAKERSFIELD FAMILY MED CENTER SiteID: 215-000-001480 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 02/22/2000 Release Containment ~ 02/22/2000 HOW DO YOU CONTAIN A HAZARDOUS MATERIALS RELEASE???????? 02/22/2000 Clean Up HOW DO YOU CLEAN UP A HAZARDOUS MATERIALS RELEASE????? Other Resource Activation 6 02/2812000 F~BAKERSFIELD FAMILY MED CENTER SiteID: 215-000-001480 Fast Format ~ Site Emergency Factors Overall Site Special Hazards ~ Utilit~Shut_Offs 02/22/2000 WHERE ARE THE FOLLOWING UTILITY SHUT-OFFS??????? A) GAS - B) ELECTRICAL - C) WATER - D) ANYTHING SPECIAL -Ko ~- El DO ¥O~ ~VE A LOCK BOX - v ~E~ ~~' Fire Protec./Avail. Water 02/22/2000 PRIVATE FIRE PROTECTION - WHAT IS IT??????? WHERE IS THE NEAREST FIRE HYDRANT LOCATED - ???????? ~ Building Occupancy Level -7- 02/28/2000 : BAKERSFIELD FAMILY MED CENTER SiteID: 215-000-001480 Fast Format = Training Overall Site -- EmploYee Training 02/22/2000 HOW MANY EMPLOYEES DO YOU DO YOU~{AVE MSDS SHEETS, ON FILE FOR YOUR HAZARDOUS MATERIALS.AND WHERE?2???? GIVE A%BRI~F S Y OF YOUR TRAI~IN~ P~OGRAM:'. ~ ~9~09aC -- Page 2 -- Held for Future Use Held for Future Use -8- 02/28/2000 HAZARD COMMUNICATION PROGRAM FOR BAKERSFIELD FAMILY MEDICAL CENTER Rev. 10/97 INTRODUCTION: ~ Bakersfield Family Medical Center, has developed a Hazard communication Program to enhance our employees' health and safety. As a company we intend to Provide information about chemical hazards and other hazardous substances, and the control of hazards via'our comprehensive Hazard Communication Program which includes container labeling, Material Safety Data Sheets (MSDS) and training. ~ The following program outlines how we,will accomplish this objective. 3 1. CONTAINER LABELING It is the Policy of this company that no container of hazardous substances will be released for use until the following' label information is verified: * Containers are clearly labeled as to the contents * Appropriate hazard warnings are noted * The name and address of the manufacturer are listed This responsibility has been assigned to C~ntral Supply Supervisor. To further ensure that employees are aware of the hazards of materials used in their work areas, it is our policy to label all secondary containers.. The Departmental Supervisor in each section will ensure that all secondary containers are labeled with either an extra copy of the original manufacturer's label or with generic labels which have a block for identity and blocks for the hazard warning. 2. MATERIAL SAFETY DATA SHEETS (MSDS) Copies of MSDS for all hazardous substances to which employees of this company may be exposed are kept in Administration and Urgent Care. The Central Supply' Supervisor will be responsible for obtaining and maintaining the data sheet system for the company. The Safety Director will review incoming data sheets for new and significant health/safety information. He/she ~will see that any information is passed on to the affected employees. (If alternatives to actual data sheets are.used, provide a description of the system.) MSDS will be reviewed for completeness by the Safety Director. If an MSDS .is missing or obviously incomplete, a new MSDS will be requested from the manufacturer. Cal/OSHA will be notified if a complete MSDS is not received. MSDS are available to all employem~ in their work area for review during each work shift. If MSDS are not available or new hazardous substance(s) in use do not have MSDS, please contact the Central Supply Supervisor immediately. Bakersfield Family Medical Cente= will not conduct any in-house evaluation of the physical/health hazards of incoming chemicals. We will rely. on the information on the MSDS provided by the manufacturer for all training and emergency response procedures. 3. EMpLoyEE INFORMATION AND TRAINING Employees are.to attend a health and safety orientation set up by the Safety Director, prior to starting work for information and training on the following: * An overview of the requirements contained in the Hazard Communication Regulation, including their rights under the Regulation. * Inform employees of any operations in their work area where hazardous substances are present. * Location and availability of the written hazard communication program. * Physical and health effects of the hazardous substances. * Methods and observation techniques used to determine the presence or release of hazardous substances in the work area. * How to lessen or prevent exposure to these hazardous substances through usage of engineering controls, work practices, and/or the use of personal, protective equipment. * Steps the company has taken to lessen or prevent exposure to these substances. * Emergency and first aid procedures to follow if employees are exposed to hazardous substance(s). * How to read labels and review MSDS to obtain appropriate hazard information. * Written documentation of employee ~raining will be maintained by the Safety Director. NOTE: It is critically important that all of our employees 'understand the training. If you have any additional questions, please contact Administration. 'When new hazardous substances are introduced, the Safety Director and the Central Supply Supervisor will .review the above items as they are related to the new material in your work area. WRITTEN HAZARD COMMUNICATION EMPLOYEE TRAINING PROGRAM Our employee training program has been developed on the basis of groups (types) of hazardous substance(s) used and common hazards associated with them. For.specific hazard information on each brand of material, the MATERIAL SAFETY DATA SHEETS (MSDS) must be reviewed. OVERVIEW OF THE HAZARD COMMUNICATION REGULATION The Hazard Communication Regulation is intended to ensure that both employers and employees are aware of the dangers associated with hazardous substances in their workplaces. The following information is a review of the specific requirements of a hazard communication program, including container labeling, MSDS and training. WRITTEN HAZARD COMMUNICATION PROGRAM We have a written program that outlines how we will provide information and control your exposure to hazardous substances. This plan is available for your review during our training and at Administration and Urgent Care for review during your workshift. HAZARDOUS SUBSTANCES USED IN OUR WORKPLACE At Bakersfield Family Medical Center we use a variety of products. Most of these products contain one or more hazardous substances. A hazardous substance inventory list is provided within the Written Hazard Communication Program for the employee to review. - READING LABELS AND' MSDS L~BELS= A product label on both the original and secondary' containers should be reviewed prior to working with the' material. Each label will have two important pieces of information you should be familiar with: 1. The Identity of the Hazardous-Substance 2. Hazard Warnings The label on the original container will also state the name and address of the manufacturer. The label should act as a visual reminder of the information we have presented in this training session and of the information found in more detail on the MSDS. It is ,essential for your safety that you read the Hazard Warning and only use the Hazardous Substance(s) within the guidelines, prescribed on the label. Questions concerning the label should be directed to your supervisor. MATERIAL S~FETY DATA SHEETS '(MSDS).: The MSDS is the primary means used to convey the necessary information about the hazards of the substances we use. The manufacturers and importers are responsible for providing us with the MSDS. The manufacturer must provide us with adequate information to use the substance safely. 5. INFORMIN~ CONTRACTORS ~ To ensure that outside contractors work safely in our plant, it. is the responsibility of Administration to provide " contractors .the following information: * Hazardous..substances to which they may be eXPosed. while on the jobsite. * Precautions the employees may take to lessen the possibility of exposure by usage of appropriate -protective measures. If anyone has questions about this plan, contact Bakersfield Family Medical Center Administration. Our plan will be monitored by the Medical Director to ensure that the 'policies are carried out and that the plan is effective. ) PHYSICAL AND HEALTH HAZARDS OF THE HAZARDOUS SUBST]tNCE(S) USED EmplOyees are to be trained specifically about the hazards of the substances in their work areas. This may be d6ne by specific Hazardous Substance(s) or by categories of hazards, but in any case, the employee is to be aware that information is aVailable on the specific hazards of individual Hazardous Substances through MDSDs. Employees may be trained using the common type or generic chemical group or by reviewing the specific MSDS, as long as thew training includes the following information: 1. Measures to protect employee from the hazards (i.e., work practices, engineering controls and the use of personal protective equipment. 2. The physical and health hazards of the Hazardous Substance(s). 3. Detection of release of the substance; emergency and first aid procedures. PHYSICAL AND HEALTH HAZARDS · OF THE HAZARDOUS SUBSTANCE(S) USED Employees are to be .trained specifically about the hazards of the substances in their work areas. This may be done by specific Hazardous Substance(s) or by categories of hazards, but in any case, the employee is to be aware that information is available on the specific hazards of individual Hazardous Substances through MDSDs. Employees may be trained using the common type or generic chemical group or by reviewing the specific MSDS, as long as thew training includes the following· information: 1. Measures to protect employee from the hazards (i.e., Work practices, engineering controls and the use of personal protective equipment. 2. The physical and health hazards of the Hazardous Substance(s). 3. Detection of release of the substance; emergency and first aid procedures. BAKERSFIELD FAMILY MEDICAL CENTER HERITAGE PHYSICIANS NETWORK MEDICAL WASTE MANAGEMENT PLAN OCTOBER, 1997 Reviewed and Approved by: BAKERSFIELD FAMILY MEDICAL CENTER HERITAGE PHYSICIANS' NETWORK MEDICAL WASTE MANAGEMENT PLAN TABLE OF CONTENTS: Page Responsibility ....................................................................... . . ..2 Description and addresses of facilities ............................................. 2-3 Waste Generation by type ............................................................ 3 Mixed waste 3 Waste Generation per site ............................. 3 Onsite Treatment of Generated Waste.., .......................................... 4 Medical Hazardous Waste Removal and Treatment ............................. 4 Recordkeeping ................................................................. 4 Temporary Storage of Medical Waste .......................... 4-5 Disposal of Medications ................................................................ 5 Sharps Disposal ................................. · ......................................... 5-6 Disposal of Human Waste ........................................................ , .... 6 Cleaning of Storage Waste Containers ............................................. 6 Cleanup of Medical Waste Spills .......................... 6 7 Disinfectant Use Onsite ................................................................ 7 Biohazardous Materials Back-up Plan .......................................................... 7 ltERITAGE PiiYSICIANS' NETWORK BAKERSFIELD FAMILY MEDICAL CENTER MEDICAL WASTE MANAGEMENT PLAN As a health care provider, it is our intention to fully comply with the Medical Waste Management Act. We recognize the necessity to protect our employees, patients, and community from the dangers of medical waste and set forth this plan in compliance with the requirements of the aforementioned act. Responsibility The responsibility tbr assuring compliance with this written document rests with the Quality Management Director. The Infection Control Committee reviews and evaluates the program's efficiencY on an annual basis or more often as necessary and makes any recommendations to the QM Director. Records of waste disposal and/or treatment are · -maintained by the Director of Purchasing. Both of these directors may be found at the following address: \ Bakersfield Family Medical Center 4580 California Avenue Bakersfield, CA 93309 805-327-441 l Facility Heritage Physicians Network (HPN) is a multil'acctcd aggregate of health care providers offering extensive ambulatory health care services to thc consumer in numerous facilities in the Kern County area. Bakersfield Family Medical Center (BFMC) constitutes the largest and most concentrated facility of providers and services. The addresses and phone numbers ofall other such facilities arc as follows: Bakersfield Family Medical Center Oak 'free Medical Center 4580 California Avenue 432 S. Mill St Bakersfield, CA 93309 Tehachapi, CA 93561 (805) 3274411 " (805) 823-2273 Oak 'Free Pediatric Group Courtyard Family Medical Group 116 W. "E" St. 2300 7"' St. ~ Tehachapi, CA 93561 Wasco, CA 93280 (',... (805) 822-4421 (805) 758-6455 60 Facility sites, addresses, and phone numbers continued: Arvin Family Medical Group Kern Valley Medical Center 146 N. Hill 6404 Lake Isabella Blvd. Arvin, CA 93203 ' Lake Isabella, CA 93240 (805) 854-3131 (619) 379-24 ! 5 Almondgrove Family Medical Group Delano Family Medical Group 10014 Rosedale Hwy. 1508 Games Hwy. Bakersfield, CA 93312 Delano, CA (805) 721-2220 (805) 5894412 Waste Generation As an aggregate, ItPN is registered With the EPA and the local agency as a large quantity generator, generating more than 200 pounds of waste monthly. The waste generated may be categorized as follows: · Blood or body fluids - liquid blood elements or other regulated body fluids, or articles contaminated with blood or body fluids; · Sharps - syringes, needles, blades, broken glass; · Biohazardous waste in the form of live or attenuated vaccines used in human health care and medications used in the treatment of human health disorders. No medical wastes are produced which contain or are comprised of recognizable anatomical remains. No pathological or chemotherapeutic waste is produced by any of the HPN facilities. Mixed waste as a result of radiographic processing is produced. The waste composition is photographic sludge and photographic "fix" solution (98% water). It is stored in a sealed recycling unit in the BFMC Radiology department and removed twice weekly by Sigma Medical Imaging, PO Box 12383, Fresno, CA 93777. The local division's phone is (805) 861-9729. Average monthly medical waste generation per site: Bakersfield Family Medical Center: 900 pounds. Oak Tree Medical Group: 100 pounds. Oak Tree Pediatric: !0 pounds. Courtyard Family Medical Group: 50 pounds. Delano Family Medical Group: 14 pounds. Arvin Family Medical Group: 20 pounds. Kern Valley Medical Center: 25 pounds. Northeast Physician Medical Group: - 80 pounds AImOndgrove Family Medical Group: - 12 pounds 61¸ Onsite Treatment of Generated Waste HPN docs'not, at any of its facilities, treat in any way, medical hazardous waste nor is any waste transported to and/or accepted for treatment at any of its facilities.. Medical tlazardous Waste Removal and Treatment ; The company contracted by HPN to remove, haul, and dispose of medical waste is as follows: B.F I. Medical Waste Systems 4135 West Swift Avenue Fresno, CA 93722 (209) 275-0991 Recordlceeping of Waste Disposal After waste has bccn treated and/or disposed, records of pertinent action arc provided to the Director of Materials Management. ;rhcse records are maintained in binders for a period of not less than three years. Temporary Storage of Medical Waste Medical waste, other than "'sharps" waste, generated in any of thc HPN facilities is bagged in red biohazardous-labeled bags, tied and placed in red metal step-on trash containers identified by both the word "Biohazard" and the international biohazard symbol. At BFMC, the Housekeeping staff make frequent rounds during the day to pickup this waste. Sharps containers for the storage of syringes, needles, blades and broken glass, the heavy plastic wall-mounted containers marked with the international biohazard symbol, arc replaced as they approach thc three-quarters or full mark. BFMC Housekeeping staffcollects the bagged and tied waste and transports it in covered rigid plastic rolling bins clearlymarked with the international biohazard symbol and the word "Biohazard" to a large secured metal trash bin in the corner of the facility's parking lot. This trash bin is designated solely for the purpose ofstoring medical waste and is clearly marked with the biohazard symbol on the lid and sides, b Cter deposit of medical waste, the bin is re-locked. Because the waste is stored at temperatures above 32 degrees Fahrenheit, at lea.~'t iWice weekly, BF! haulers pick up the waste for transportation to the disposal facilities, ifnecessary, BFI may be called for additional pickups. Pickup at the satellite facilities by BF! is weekly, or more frequently as necessary. Until pickup, all medical waste is maintained in secured bins. 62¸ - Ail patient-usc linen items arc disposed of into yellow plastic linen bags clearly marked for linen only. Used linen should never be placed in red plastic bags as this indicates that the items contained are for hazardous materials disposal. All linen is considerable re- useable after appropriate laundering. Disposal of Medications Empty medication vials are to bc placed in thc sharps containers for disposal by BFI. Do not throw the vials in the general trash. Expired drugs are to be returned to the Materials Management office. However, expiration of drugs is to be avoided if at all possible by careful and frequent checking of' the expiration dates. Drugs that are due to expire within a month are to be returned to the Materials Management office for a refund. Sec the Nursing Policy and Protocol for this procedure. · Medication in tablet or capsule form is not to be flushed down the toilet as'this violates the community hazardous material management plan. Liquid medication may not be poured down either the sink or the toilet due to the same regulation. All tablets, capsules and liquid medications are to be sent to Materials Management for appropriate disposal. Sharps Disposal Immediately after using needles of any type or surgical blades, these must be disposed of in the nearest and most convenient sharps container. Never remove a needle from the syringe hub. Vacutainer needles can be removed by twisting the needle in the slot provided on top of the sharps container. This is done by wedging the needle into the slot and turning the vacutainer casing in a Counterclockwise direction. Never recap a used needle. Sharps containers are conveniently located in each patient exam room and at nursing stations throughout all facilities. Used needles and syringes must be disposed of at the point of generation, i.e., ifyou gave an injection in a patient exam'room, dispose of the needle and syringe in that room. Do no handle used surgical blades with even gloved hands. Usc either a pick-up or a kelly to move the blade'from the table of origin to the sharps container. Broken glass should never be handled with bare hands or even hands gloved with examination gloves. Utility or heavy rubber gloves are necessary to remove broken ~lass to a sharps container. A small broom and dust pan may be necessary to safely remove the -' glass. 63. Disposal of Human Waste Normal human waste, i.e. urine, feces, vomitus, crc., may bc disposed of by discharging it into thc public sewage disposal system. This type of normal waste is normally flushed down the toilets or hoppers. No additional treatment of such waste is undertaken. Cleaning of Storage Waste Containers Sharps containers arc not re-useable. Thc complete unit is disposcd ofas medical hazardous waste. BFI processes thc entire container as medical hazardous waste. The red metal containers used as storage units within the facilities are rarely contaminated since they are always lined with red bags. l-lowever, in case of accidental leakage into one of these containers, the following procedure is to be followed: I. Remove leaking bag and place it immediately into a second red bag. Tie securely. 2. Depending on the amount of liquid waste, use absorbent paper towels or the Emergency Spill Kit to contain the spill. 3. Place the contaminated paper towels or absorbent material into another red bag. 4. Spray the insides, bottom, and inside of the lid with Dispatch. Allow the solution to remain in contact with the surfaces as long as specified by the manufacturer. 5. Wipe dry with additional paper towels. 6. Dispose of these paper towels into the remaining red bag. Tie securely. Routine maintenance of the red metal containers includes weekly cleaning with Dispatch on a regular schedule. After the containers dry sufficiently, a fresh red bag is used to line each container. The maintenance of the outside storage bin is the responsibility of BFI. Cleanup of Medical Waste 5'pills HPN maintains in all facilities the Biohazard Spill Kit for cleanup of medical hazardous waste. Each facility has these kits in strategic locations or available from the Housekeepers as needed. At BFMC, every nursing station and reception area is equipped with these kits. The technique and protocol for medical waste spill cleanup is as follows: I. Contain the spill with available materials (i.e., paper towels, drapes, etc.) until the Biohazard Spill Kit becomes available. 2. Follow the directions accompanying the kit: a. Wear gloves provided; b. Sprinkle the absorbent material over the spill; Clean-up continued: - c. 'Using the provided broom and dust pan, sweep the spilled materials into a small pile and then onto the dust pan; d. Empty the contents of dust pan into provided red bag; e. When finished, place the broom, dust pan and any materials used to contain the spill into the red bag; f. Remove gloves and drop into red bag; g. Tie the bag securely with provided tie; h. Dispose of red bag into red metal biohazard container; i.' Spray the area of the spill thoroughly with Dispatch and allow contact with contaminated surfaces for ten minutes; j. Don second pair of gloves. Wipe or mop up Dispatch. Dispose of second pair of gloves into red metal container at, er completing the cleanup. Treat mop head as any other contaminated, reusable item per the Housekeeping protocols. k. Wash hands thoroughly. Disinfectant Use Onsite a) All HPN facilities utilize a hypochlorite solution, Dispatch, for disinfecting contaminated surfaces. This is a 10% concentration of hypochlorite in water with inert additives for odor remediation. Under normal circumstances, the solution is sprayed onto the contaminated surfaces and contact is maintained for ten or more minutes, or per the manufacturer's specific written directives. BIOHAZARDOUS MA TERIALS BACK- UP PLAN If for any reason our contracted Biohazard Materials Removal Contractor is unable to remove our waste, our contingent plan is as follows: 1. Commandeer a regular waste bin. 2. Lock the bin (locks and keys are in the Purchasing Dept.). 3. Mark the bin as containing biohazard materials (biohazard labels are in PurChasing Dept.).