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Home My WebLink AboutHAZ-WASTE REP. 2/3/2000 Hazardous Materials/Hazardous Waste Unified Permit cONDITIONS OF PERMIT ON REVERSE SIDE ................... ~,~,,~,~,,,,~,~,,,, ............... This permit is issued for the following: · ~,,¢i':i':':i' ?~ ;~:'~i:~'~"*"i;i !i i; i;;:::'iiii"i~,ii~;U~e[ground Storage of Hazardous Materials BAKERSFIELD FAMILY MED LOCATION ' 4580 CALIFORN!A,::'?¢,~,~::f?' BA~EASAiELD ca 9330~?.::,~¢~,'~'::::~:~,. ' ,. ........... t ~ . , , ,~..~ ..... .,., , .~,1 . . Bakersfield Fire Depa~ment Approv~ by: O~ICE OF EN~RO~AL S~ ~CES 1715 Cheaer Ave., ~rd Floor B~ersfiel~ CA 93301 ~o,c~ ~0,~,~-,,,, 30 2000 ~'~o ~i:~ CITY OF BAKERSFIEI~ OI~FICE OF ENVIRONMENTAL ~ERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 **~'~"~ H~RDOOS MATERIALs INVENTORY CHEMICAL DESCRIPTION (one ~ pe~ mammal ~ NEW ~DD ' 0 ~ ~ ~ISE ~ Page __ BUSINESS ~E (~e ~ ~ACIL~ ~ ~ D~ - ~ B~ ~) CO~N ~ EHS* FIRE ~DE ~ C~E~ (~ E ~ ~ ~ ~ ~ FED ~ ~ES D 1 FI~ * D 2 ~ ~ ~ ~ O 4 A~ H~ D 5 ~NIC H~ (~ ~ ~ ~) A~U~ ~LY ~U~ ~ILY ~U~ DAYS UN~S' ~ ~ ~ ~ ~ ~ ~ ~ D ~ TONS ' ff ~S. ~t m~ ~ In I~. STOOGE ~AINER ~ a ~U~ T~ ~ · ~N~C ~UM ~ i FIBER DRUM (~eck ag ~at a~) ~ b U~UNDT~ ~ f ~ ~J ~G D n ~c ~ ~ r O~ER ~ c T~ I~1~ ~1~1~ ~ g ~Y ~ k ~X D o TO~ BIN ~ d ~ ~UM ~ h SILO ~UNDER ~ p T~KWA~N STOOGE P~SSU~ ~ · ~1~ ~ ~VE ~1~ ~ ~ BELOW 3 ~ ~5 ~y~ 5 242 · 2~ PRI~ ~ & T~E OF A~ R~D ~A~ ~8E~ATNE SI~TU~ UPCF (71gg) S:~CUPAFORMS~OES2731.TV4.wI:x:I ~ CITY OF BAKERSFIEI~ r OPFICE OF ENVIRONMENTAL ~'ERVICES 1715 Chester Ave., CA 93301 (§61) 326-3979 H~RDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one ~ ~r ma~al NEW ~O ~ OE~ ~ ~ISE ~ Page BUSINESS ~ (~e ~ FACIL~ ~ ~ D~ - ~ng B~ ~) CHEMI~LL~/ION ~ I~ ~ ~ ~l~ ~ ~ ~ .... - / ~ ~1[ ~E~LLO~TION ~AC,L,~,o~ ' ~ ~ ~ ~(~ · ~3 GR,D~ ~ [ T~E SE~ CHERYL ~ FI~ ~DE ~ ~ES (~ ~ ~ ~y ~ ~ ~ ~PE ~ ~ ~ m ~ - ~ w WA~ 211 J ~D~A~ ~Y~ ~ 212~ CURIES (~ ~ ~ ~) A~ H~ 5 ~BNIC H~ · ~,~m~ln ~. STOOGE ~AINER ~ a ~U~ T~ ~ · ~N~ ~UM ~ i FIBER DRuM ~ m ~ ~ ~ (Ch~k all ~at ~) ~ b U~R~UND TANK D f ~ ' ~ j ~G D n ~c BO~E ~ r O~ER ~ C T~ [~l~ ~l~l~ ~Y ~ k ~X ~ o TO~ BIN ~ d ~ ~UM ~ h SILO ~ I CYUNDER ~ 9 T~K WA~N STO~ ~U~ ~ a ~1~ ~ ~ MI~ ~ ~ B~OW A~IE~ STO~GE~~ D a~l~ ~ ~ ~1~ . ~ ~ B~OW~IE~ ~Y~ENIC 242 2~ ~ y. ~ ~ ~ ~1~ ~ & T~E OF AU~OREED ~ ~A~ ~SE~A~E I~TU~ UPCF (7199) $:\CUPAFORMS\OES2731.TV4.w~d ~ r O~CE OF EN.~RO~NTAL ~RVICES 171~ Chester Ave., CA 93301 (661) 326-3979 H~RDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION , . (one ~ ~er ma~l ~r ~ or a~) ~ NEW ~ ~L~E ~ ~ISE ~ Page". CHEMI~L LO~TION ~1~NFIDE~CHE~L LO~TION(EPC~) ~ Y~ ~ No ~2 T~E SEC~ ~PE ~ p ~ ~ m ~ ~ WA~ 211 I ~D~A~ ~Y~ ~ 212 CURIES ~3 PHYSI~ STA~ ~s ~MD ~ ~UID ~ g ~ 214 ~ ~ST~R ~ . FED ~D ~ES ~ 1 FI~ ~ 2 ~ ~ 3 ~ ~E D 4 A~ H~ ~.~NIC H~ UN~S' ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ m TO~ ~ ~ * ~S,~t m~ ~. STO~GE~AINER ~a ~uNDT~K ~~N~C~UM ~i FIBERDRUM ~m G~SBO~ Dq ~IL~ (Check all ~at ap~) ~ b U~R~UND T~K ~ f ~ ~ j ~G ~ n ~C ~E ~ r O~ER L~. ~ c T~ INSI~ BUI~I~ ~ g ~Y ~ k ~X ~ o TO~ BIN ~ d ~ ~M ~ h SILO ~ I C~INDER ~ p T~K WA~N STOOGE P~U~ ~a ~1~ ~ ~ ~1~ ~ ~ BELOW~IE~ ~4 STOOGE e~ ~ ~~ . ~ ~ B~OW~IE~ ~ c ~Y~ENIC 2 ~ ~ ~1 ~ Y~ ~ ~ ~2 ~ ~9 ~ Y~ ~ ~ 2~ 242 ~3 ~Y~ ~ 2~ PRINT NAME & TITLE DATE 246 UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd CITY OF BAKERSFIELD FIRE DEPARTMENT . OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME '1~ ["~"1C..- INSPECTION DATE Z/3/~:::~0¢..~ Section 4: Hazardous Waste Generator Program, EPA ID # ~-----~ '~ ,~ Routine [] Combined [] Joint Agency [] Multi-Agency. [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous xvaste determination has been made EPA 1D Number (Phone: 916-324-1781toohtainEPAID#) Authorized for waste treatment and/or storage Reported release, fire, or explosion xvithin 15 days ofoccurance Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking t/" Containers are compatible with the hazardous waste Containers are kept closed xvhen not in use Weekly inspection of storage area 1/ Ignitable/reactive waste located at least 50 feet fi-oin property line Secondary containment provided ( Conducts daily inspection of tanks Used oil not contaminated with other hagardous 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 3 Retains manifests lbr 3 years Retains hazardous waste analysis for 3 years Retains copies of used ()il receipts fi)r 3 years Determines if waste is restricted fi'om land d'isposal C=Compliance V=Violation Office of Environmental Services (805) 326-3979 Business Site Responsible Party \Vhite'- Env. Svcs. Pink - Business Copy STATE (~: CALIFORNIA--CALIFORNIA ENVIRONME~PROTECTIO~q AGENCY · ' ' PETE WlLSONrGovernor DEPARTMENT OF TOXIC SLTBSTANCES CONTROL -400 P STREET, 4TH FLOOR ' ' .P;O. BOX 806 SACRAMENTO. CA.95812:0806 - ' (916) 323-5871 -' "- - · CAD983617044 BAKERSFIELD FAMILY MEDICAL CENTER 4580 CALIFORNIA AVE DEAN WORK BAKERSFIELD, CA 93309 4580 CALIFORNIA AVE '' BAKERSFIELD, CA 93309 .... DATE WITHDRAWN: 04/18/95 .. Dear Onsite Treatment FacilitY: You have ~ecently requeSted to withdraw your Onsite Hazardous Waste Treatment Notification (DTSC Form 1772) for your facility 'to operate under permit by rule, 'and/or conditional authorization, and/or conditional exemption. We have reviewed your letter, and have approved your request to withdraw your notification. We are also removing you from .the Tiered Permitting data system. You stated 'that you want to withdraw because: FACILITY USING RECYCLING METHOD . . If you treated hazardous waste at any time in the past, you may be subject to past annual fees as a hazardous waste. facility fro' acting in a manner requiring a treatment permit. Most facilities authorized to operate under permit by rule or a grant~.of conditional authorization or exemption are forgiven these retroaqtive facility fees. By withdrawing your form DTSC 1772, you will not be eligible for that exemption. These fees total at least $10,000 a year depending on the quantity of .waste treated. By submitting a notification udder permit by Rule, Conditional Authorization or Conditional Exemption, you became subject to payment of the PBR annual fee ($1,140.in 1993) and/or the CA annual fee ($1,140 in 1993) and/or the CE fee ($100).. Your fee payments for the withdrawn notification will be refunded under separate cover. If you.have any questions or need further information, please call the appropriate regional office, or call the Onsite · - Hazardous Waste Treatment Unii at the letterhead address. Sincer.e,!y, Michael S. Homer, Chief Onsite Hazardous Waste Treatment Unit cc: ASTRID JOHNSON · ~' DTSC REGION 1 ' STATE REGULATORY PROGRAM 1515 TOLLHOUSE'. CLOVIS, CA 93611 Page 2 ' ' EPA ID #: cAD983617044 STEVE MCCALLEY KERN COUNTY ENVIRON. HEALTH SERVICES DEPT 2700 M STREET, SUITE 300 BAKERSFIELD, CA 93301 - STATE BOAI~D OF EQUALIZATION STEPHEN R. RUDD, ADMINISTRATOR - ENVIRONMENTAL FEES DIVISION P.O. BOX 942879 SACRAMENTO, cA~ 94279-0001 BAKERSFIELD ~ MEDICAL j~ CENTER 4580 California Avenue, Bakersfield, CA 93309_ (805) 32~-441 . . , [ : RECEIVED BY: :" ~/ '. ~ APR 1 1 1995 Mr. Mike, Horner' Chief of OffiCe ...................... ~'~ ..... On-Site Hazardous Waste poTreatment UnitBox 80.6 ~ · Sacramento, CA 9.5812-0806 Dear 'Mr. Homer, We would like to .be' taken off the Tier-Permit list. We have been using the recycling method since October 9, 1992. The proper paper work was sent to you in March 1993. The following process falls in line with the-HSC 25143.2 (c) .(2): a) Processor is coupled with Siltech F-100R Recycling . unit. b) While'.processing, spent x-ray fixer is transferred to the recycling machine for physiCal separation. A ..~. percentage of spent fixer (usually in excess of 60%) is transferred back into the replenishment"tanks .for reuse. The-balance (generally 40% or lesS) is hauled off. for off-site treatment-. c) The recycling machine is inspected and serviced on a regular basis. All residues are cleaned to enSure quality of recycled fixer. Sincerely, .. Dean Work, Director'of Radiology cc: Larry ShUmate Kern County Environmental Health DePartment BAKERSFIELD · MEDICAL : d CENTER · - 4580 California Avenue, Bakersfield, CA 93309 (805) 327-4411 April 6, 1995 Mr. Mike Homer Chief of Office On-Site Hazardous Waste Treatment~Uni-t PO Box 806 Sacramento, CA 95812-0806 Dear Mr. Morner, We would like to be taken off the Tier-Permit list. We have been using the recycling method since October 9, 1992. The proper paper work was sent to you in March 1993. The following process _I//falls in line with the HSC 25143.2 (c) (2): a) Processor is coupled with Siltech F-100R Recycling Unit. b) While processing, spent x-ray fixer is transferred to the recycling machine for physical separation. A percentage of spent fixer (usually in excess of 60%) is transferred back. into the replenishment tanks for reuse-. The balance (generally 40% or less) is hauled off for off-site treatment. c) The recycling machine is inspected and serviced on a ___ regular basis. All residues are cleaned to ensure ~ua*litY--6-f re~Ycl~d-fixe~.- .... - ....... ~ Sincerely, Dean Work, Director of Radiology cc: .~a~,¥~Sh.u~ Kern County Environmental Health Department DEPARTMENT OF TOXIC SUB CES CONTR"~'~ ' ~ ~~.]RT ~ ~C~ON ~RT FOR Pe~t b~ R~e, Con~fio~ ~u~o~d~ ~d Con~tio~ ~p[ ~CO~: PB~ CA C~W / '~ TOT~ / ~ CO~(no~): PB~ CA' ~W C~ TOT~ NO · 1. Con~genc7 p]~ ~ ~n prep~ (adeptly ~~ rel~s, h~ ~commud~5on sys~m, Hs~ emergency ~pmcnt ~d phone numbers for emergency c~r~ators). 2. Written t~inlng d~-men~ and r~or~ pr~ for employ~ h~d~g h~dous w~. 3. M~t con~er m2nng~t s~ds (stooge time hmia, close, labell~, compafib~i~, ~~ w~y, ~ g~ ~ndifion, wia ig~l~r~cfiv~ 50-f~t ~om pro~ Hne). 4. M~t ~ mnagement s~ds (eider ~on~ con~ment or ~~ ~ssmen~, plus stooge time h~5, h~H~, com~fib~, ~t~ d~y, ~ g~ condition, igni~le~cfiv~ 50 f~t ~om pm~ ~e). 6. ~ u~ under PBR, CA, ~d CE ~e pro~rly ~dicat~ on Form DTSC 1772. (Add ~y new u~a ~ u~t sh~ or co~t der on ~e u~t sh~t.) 7. ~ gene~tor iden~tion ~fo~afion on Fo~ DTSC 1772 is co~t. 8. · '~e sub~ plot ph~map ad~tely shows ~e l~afion of ~1 regulat~ u~. .9. ~ere ~e r~ords d~umen~g compli~ce wi~ ~wer agency pretr~ent ~ndar~ ~dus~ w~ dish,ge r~ukemenB, where applicable. 10. Gene~tor h~ prep~/m~n~ source reduction documen~ r~ukemenB (SB 14/SB 172~. For m~Y w~tes, a christ or pl~ is r~uir~ only ~ ~u~ h~dous w~te volume is over 5,~ ~og~s (a~rox 11,~ ~unds or 1,350 g~lonS).' HSC 25244.15,252~. 19-.21 For CA or PBR not,em: "11.. ~e gene~tor h~ ~ ~nu~ w~e ruination ce~ficafion. ~BR submit wi~ renew~s.) Onsite Ch~Eist (A) Page 1 of .l~u~ 1, 1995 STAT~ OF CALIFORNIA:ENVIRONMENTAL PROTECTION AGENCY PETE WILSON, Governor DEP'A'RTMENT OF TOXIC SUB ~S~NCES CONTROL REGION 1-1515 Tollhouse Road Clovis, CA 93612 CREC~T ~ ~ VE~RIF[CAT[ON I~SPEC~[ON REPORT :FOR Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers UNIT SHEET Complete one unit sheet for each unit either listed in the notification or identified during the inspection.. Unit N. mber: . Unit Name: Notified Tier: Correct Tier:. Notified Device Count: Tanks Containers Correct Device Count: Tnnks Containers For each Unit: ~ 12. All hazardous wastes treated are generated onsite. - 13. The unit notification is accurate as to the number of tank(s) and/or container(s). 14. The estimated notification monthly treatment volume is appropriate for the indicated tier. 15. The waste identification/evaluation is appropriate for the tier indicated. 16. The wastestream(s) given on the notification form are appropriate for the tier. 17. The treatment process(es) given on the notification form are appropriate for the tier. 18: The residuals management information on the form is correct and documented for the unit. 19. The indicated basis for not needing a federal permit on the notification form is correct. 20. There are written operating instructions and a record of the dates, volumes, residual management, and types of wastes treated in the unit. 21. There is a written inspection schedule (containers-weekly and tanks-daily)~ 22 There is a written inspection log maintained of the inspections conducted. 23. If the unit has been closed, the generator has notified DTSC and the local agency of the clOSUre. For each CA or PBR unit: 24. The generator has secondary containment for treatment in containers. For. each PBR unit: 25. There is a waste analysis plan 26. There are waste analysis records. 27. There is a closure plan for the unit. Unit Comments/Observations: gf this is a unit that was not incZu,led on the notification form, the violation is operating without a perrnit-HSC 25201(a). Al~o note if the activity is currently ineligible for onsite authorization.) Onsite Checklist (B) Page of lanuary 1~ 1995 :'STATE'OF -C_..ALIFORNIA;ENVIRONMENTAL PROTECTION AGENCY -PETE w1L~N.'Go~arnor DEPARTMENT OF TOXi CONTROL · REGION 1-1515 Tollhou~ Road ~Clovis, .CA 93612 CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT. FOR Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers SIGNATURE SHEET Onsite Recycling:~ Only am'wer if this facility recycles mare than I00 kilograms/rnonth'of, hazardous waste onsite. 28. _ The a~propriaie local'agency has been'nOtified. HSC 25143.10 " 29. Activities Claimed under the omite recycling exemption are appropriate. HSC 25143.2 et sec. Releases: - If there hat been a release, ·provide the following information: number of releases, date(s), type(s) and quantity of materials/waste, and the c..~e($). Use um't sheet or attach additional pages. YES,.' '· · '30. Within the last three year~, were the~e any 'unauthorized or accidental releases .to the environment of hazardous waste or hazardous waste constituents from onsite treatment units? 31. Within the last three years, were there any.unauthorized or accidental releases to the environment of hazardous waste or hazardous waste constituents, from any location at this facility?., · For purPoses of a Tiered Permitting inSPection' an unauthorized and/or accidental release to the environment does not include spills, contained within containment systems. This report may identify conditions observed this date that are alleged to be violations of one or more sections at the California Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management of hazardous waste. The violations may be described in more detail on the attached note sheets. 'If any violations are noted, the facility is required to the submit a signed Certification of Return to Compliance within 60 dhys, unless otherwise specified. (A certification form is provided.) If any corrections are needed to the initial notification, the facility will submit a revised notification within 30 days to the Department of Toxic Substances Control with a copy to the local, enforcement agency. ,. InspeCtor(s): .... Lead Inspector.: SignatUre: D,~..,/'/) ~- ~5'~L Signature: Agency: ,/-) ?~5~c Agency: Phone Number: o? o ~ ~ 2 ~ z- 3 75-~ Phone Number: FacilitY RePresentative: Your signature acknowledges, receipt of this report and does'not imply agreement with the f'mdings. 'Signature: .. · . Print Name: . Title: ' 'Date: · :- .... .Onsite Checldist (C) "' Page of August 2, 1994 STAY; OF C,~LiFORNIA-;NVIRONMENTAL~PROTECTION AGENCY . *. PETE WILSON, Governor · DEPARTMENT oF ToXIc,a~.~o-w.u~,,,c~o CONTROL · REGION I-t515 Tollhouse Ro~t. Clovis, CA 93612 '~.. CHI~CKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR -' 'Permit bY .Rule, COnditionally Authorized} and Conditionally Exempt Notifiers NOTE $1tEET .... This sheet includes inspector 'observations and expands upon the violations'identified on the checklist (by number). In some ca~es, it indicates how the facility should coPrect the violations. It also includes the names of any others participating in this inspection. : Onsite Checklist (D) Page of .. August 2, 1994 "STAT~' OF 'CAUFORNIA~ENVIRONMENTAL PROTECTION AGENCY '-' PET~ WILSON.. Governor' DEPARTMENT OF TOXIC CONTROL I~OlON 1-1515 Tollhouse Road Clovis, CA 93612 · -TIERED PERMITTING CERTIFICATION OF RETURN TO COMPLIANCE For Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers In the matter of the' Violation cited on · As Identified in the Inspection Report dated Conducted by: (agency,)) I certify under penalty of law that: 1. Respondent has corrected the violations specified in the notice of violation cited above. 2. I have personally examined any documentation attached to the certification to establish that the violations have been corrected. 3. Based on my examination of the attached documentation and inquiry of the individuals who prepared or obtained it, I.believe that the information is true, accurate, and .complete. '4. I am authorized to file this certification on behalf of the Resp°ndent. $. I am aware that there are significant penalties for submitting false information, including the possibility of f'me and imprisonment for knowing violations. Name (Print or Type) Title Signature Date Signed Company Name EPA ID. Number DTSC-RETCOMP.CRT (8/94) ONSITE B W~TE TBATME~ I~CATION FOBI FACIL~ SPECIFIC NO~FICA~ON ,: Uoder Coadifio~ Exemp6on ~d Condifio~ Au~ofi~i~. ~ Revi~ I. NOT.CATION CA~GO~S A. . .:Conditio~llY Exempt-S~l ~tity Tr~tm~t B. X ~' Condi6omlly Exempt-s~in~ ~~(Fo~ DTSC ~VV2B) S ~C~ ~ Pe~t by Rule [ ~ ~Fo~ DTSC 1772D) $I.1~ EPA ID NUMBER CA D983617044 ...... BOE NUMBER (irav~lable) H HC N~ME (Com~y or F~iliu) ~ersfield F~ly PHYSIC.~ E~A~ON 4580 ~lifomia ~ :' B~ersfieid~ C~. 93309 For DTSC U~ O~ C~' / ~ersfield, CA ZIP 93309 ~ Reglon ! J COU~ Ke~ CON~A~ PSRSON ~ ~rk PHONE NUMBER~q~7-~177 DISC ~772 (F/93) 'STREET CITY STATE ZIP COUNTRY' ~ (only complet~ if nm USA) CONTACT PE, RSON PHONE NUMBER(, ). . 'i (F'u~ Nsme) (I.as~ Name) -- ffl, TYPE= OF COMPANY: STANDARD INDU~ CLASSIFICATION (SIC) CODE: Use either one:!or two SIC codes (a four digit n;xrnbet;} that best describe your company's product~,' servlce, rl or industridl activity. Example: ~! ..7'~8d ~ $672 Printed circuit board, t i~ First: 80]_1 C, enera'l l~c_.a'l Second: N/A IV. PRIOR PERbI1T STATUS: Check yes or no to each question: yes No ! 1. Did you file a PBR Notice of Intent to Operate (DT$C Form 8a62) in 1992 for this location? status for any of these treatment units? [~ [~! ;~! 3. Do you now have or have you ever held a state or federal full permit or inter/m status for any other f~: hazardou~ waste activities at this location? ['~ [~] ii 4. Have you ever held a varianceissued b~; the Department of Toxic Substances Control for the treatment you are now notifying for. at this location? 17] [~] i: 5. Has this location ever been inspected by the sate or any local agency as a ha~,ntous waste generator? V. PRIOR", ENFORCEMENT HISTORY: Not requirt~/ from generator~ only non'f )ri'rig a~ conditionally er,~mpt. YES NO [] ~] .iWithia the last thxee years, has this facility, be~n the subject of any convictions, judgments, settlements, or f'mal ilorders resulting from an action by any local, s~ate, or f~deral envimamental, hazardous waste, or public h~alth 'i .en£orcemeat agency? ~;i'(For the pucpose~ c ~ form, a notice of violation dees not constitute an order .~.~d n~cl not b~ repotned unless .!t Wa~ not eogected .~::a l:~-ame a tiaa] order.) ,~!f you answered Y~, check th.iS b~x and attach a listing of convictions, judgments, s~ttlements, or orders and a copy of thc cover sheet from ~ach document. ($e~ the Ix~structioas for mom ~formation) Page 2 ...... ~' EPA ID NUMBER c'Ar)gR]61'/044 ~ Page 3 Of 6 1. ::~:. A plot pl~/~p de~ling ~e l~tion(s) of ~e cove~ ~it(S) ~ ~latioa to ~e f~ility ~~. ~ 2. A ~t ~ific notifi~ti~ fo~ for'~h ~t to ~ Cove~ at ~s I~fion. CERT~CATIONS: ~fo~ m~ ~ slgn~ h~ op~atlonal ~i a~ p~o~ de~iOn-~ng~io~ t~ go~ O~ion Of tht fa~li~ (~ tit~ 22, Cal~omia C~e 6~ Regu~tio~ (CCR) se~ion ~2~. 11}. W~te Minlmi~ti0n I ceai~ ~t I have a pm~ ~ place to degr~ I have d~te~M to ~ ~ono~ly p~ti~ble ~d ~at i have ~l~t~ ~ ~ti~le ~ of t~t~nt, stooge, or dis~l cu~ent!~ av~lable to ~ w~ch mifii~ ~e p~t ~d ~ ~t to hU~ h~ ~d ~ enviro~nt. Tie~ Pe~iltlhe Ce~ifi~tion I ce~ ~t ~e ~t or ~a d~fi~ ~ ~ d~.~ ~t ~ eligibili~ ~d o~mt~g r~uiremenm of,:~;smte smmt~ ~d re~fio~ for ~a ~di~ ~tt~g fi~, ~clu~s g~mtor md ~n~ con--at r~uiremenm. I~de~d ~ if my of ~e ~a o~ ~der Pe~t by Rula or Coa~ti~ Au~ofi~tioa. I ~R fl~ ~ ~ui~ to provid~ ~u~ ~ci~ ~rm~ by Jm~ 1, 1~4, md conduct a P~ I ~vi~ ~~t by J~ I, 1995. I ceaiO ~der ~nflty of law ~t ~s d~u~t md all at~chm~a w~m ~ a system d~i~M to ~m ~t q~ifi~ ~el pm~rly ga~er md evll~ta ~e ~fo~tion mb~tt~. B~ on my ~qui~ of ~e ~n or~ns who ~ge ~e system, or ~o~ di~tly ~ible for ~e~g ~e ~fo~tion, ~e ~fo~tion is, to · e ~t of my ~owl~ge md ~lief. tree, accurate, md complete, I am awa~ ~at.[~hem a~ ~bs~tial ~alti~ f~ ~b~tting fal~ ~fo~tion, ~clud~g ~e ~bility of ~ md i~~eat for ~g violation. ~N~ (~nt or T~ ~ -- ~ · Title T~G '~ P~m~ ~t, th~ ~n~rator~ tr~a~ing ~rdo~ wmtt o~ite ar~ r,q~ir~d m ~m~ ~tth a n~ of o~ing r,qulr~ whi~ d~er depe~ing~bn the ti~(~J u~ whi~ o~ opiate. ~ opiating r~qui~ ar~ ,~ fo~h in tht ~t~ ~ r, gu~iom, ~SIO~ ~OCED~S: ~D~an~ of T~c ~ubXt~c~ Control ~O~ite H~ardo~ W~te Trg~mgnt Unit P Street, 4,a F or in only) :}P. O. Box ~ ,~Sa~ento, CA 95812~. You m~t a~o ~ o~ ~ of the ~t~e~ion aM ~ta~e~$ to i~oion mat~a~.c. You m~t abo retain a ~ ~ pa~ of your oR,rating ~e~rd. All three fo~ m'~t ~ oHgi~l sig~ur~, ~t photo~pi~. DTSC 1772 (I/9~) Pag~ 3 CONDITION,4 q . EXEMIrr SPECIFIED: TREAMS ~it}; ' (pumant to He41th ~d gafety Code $ectio. 25201.$(c)) UNIT NAME~gi lmr g~cr~_ry .. , :... ~ ,...: ,,~UNIT ID NUMBER A . NUMBER OF TREATMENT DEVICES: .... 1 T~k(S),~; i' ~" Each unit mus~i~be clearly identified and labeled on the plot Ploh attachi~d to Forj~ 1772. Assign YOur own unique number to each unit: The number can be Sequential (I, 2, $) or U~inf ~ ~ti'~ j~6U Cho0$~. Enter the estirt~ated month& total volumt O/~Pdoi~ voit~t~ i~ ~r~ tht$*itdit. ~i5 should be the maximum or highest amount treated in any ~nth. Indicate in th~ tiaPratiOe (SeCtiOn II) if yOit~ Opehltlb~ha'~ ::~aional ~io~. I. WAS~STREAI~ ~ TREATI~NT PROCE~r.~.~ ~ ..... · Estimated Monthly Total Volume Tr~ted: pomad~ ~d/0r . 3,10 gallo~ The fol.?owing are the eligible wast~iftains and if~i~t~'t~f ~JkOe~.'? pi~ ~.h~ all appllcabM boxes: I--I 1. i)' Treats resins mixed in accordanc~ with the manufactti~f+a [-] 2. !i} Treat contain~m of 110 gallons or i,~ eapa¢it~ tl~t eiSiitifini~! ~id~ ~/~ by riming or physical proces.~, such as crushing, shr~Iding, giinding;' o~ panc~tin~?; .~:~¥~ ~;' ~':~! '; ~'""~"' "-'~' ? ' "-iI ~;i~:, :' "': '~' ' " I~ 3. }?-,i. Drying special wastes, as classified by the departmt Pu~,t tO title 22, CCR, section 66261.124, by preying :~.~r~ or by passive or heat-aided evaporation to remove Water. ~ 4. k Magnetic separation or ~r~ning to r~move ¢Ompon~nt~ from ~:ial wr~te, ~ cla2~ified by the dep~rtm~nt purmant '~; to title 22. CCR, ~:tion 66261.124. ~ 5. ~i~ Neutrali2~ ~Cidi60i alkaline (ba.~) wastes from th, reg~i~'afio,~ Of io~ ~XChang~ m~dia ~ to d~in~ali~ water. (Thi~ w~t~ cannot ~atain mom than 10 l~t ~id o~ ~ ~y W~iglat to b~ ~li~ibl~ for eonditi0n~l ~x~mptioo.) E] 6~ :~ Neutraliz~ ~idic or alkalin~ {base) wast~ fi-om th~ food proe~ing ind~tr7. [~ 7. .~ Recovery of silver from photofinishing. Th~'~6iUd~/~ li~t'fd~ ~n~iti~ ~Xefliption i~ 5IX) gallo~ per generator ~::. (at th, sam, location) in any calendar month. : ' . . ~',,,0! ~Occulants and demulsifiers if 8. Gravity separation Of the foll0~g~ 16ciudiag fil~ ~ :'~ ' ' " FI '~ ~ a. Th~ settling of mli~ from th~ w~t* Wh~re file r~ulting aqu*O~/liquid stream i~ not ba?a~dou~. ~ ~iii~ b. The '~Paration of oil/w;,te~ miXhir~ and ~i~'afi0h ia,i es. if th~ ,werag~ oil recove~,,ed per month i~ ie~ ~' than 25 barreb {42 gallo~ per barr~l). [-'] 9. ili Neutralizing acidic or alkaline (base) matdi'ial by a state Certified laboratory or a laboratory operated by aa ~? educational instimfioa. {To b~ eligibl~ for conditional exemptio0, this,wa~t~ cannot coatain mor~ than 10 percent ~, acid or ba.~ by W~ight.) DTSC 1772B (!=793) Page 9 ~- CONDITIONALLY EXEMPT. SPECIFIED W~AM~ ~ UNIT SPECIFIC NOTIFICATION (purmant to Health md ~fety Code .~fion ~201:5(c)) 11. NARRATIVE DESCRIPTIONS: Provide a brief description of the specific watte treated and the treatment process u~ed. 1. SPECIFIC WASTE TYPES TREATED: S~ent Used Fixer From x-raY processor 2. TREATMENT PROCESS(ES)USED: Used fixer is first treated in a' silver recovery Unit(electrolytic) and then in a steel wool cannister(ion exchange) LI/. RESIDUAL MANAGEMENT: Check Yes or No to each question as it applie~ to all reMduab from tbix treatment unit. YES NO F~] [-] I. Do you discharge non-hazardous aqueous waste to a publicly ow-ed treatment works(POTW)/s~wer? r"[. ' I~ 2. Do you discharge non-haza~ous aqueous waste under an NPDES permit? 3.Do you have your residual hazardous waste hauled offsite by a registered hn~dous was~ hauler? If you. do, where is the waste senO Check all that apply. [~] a. Offsite t~cycling ~! b. Thermal treatment I~ c. Disposal to land D d. Further treatment [-"] [~ 4. Do.you dispos~ of non-hazardous ~lid waste residu~ at an offsite location? f'l G1 s. O er,.e o ofdi o . S :ify: IV. 'BASIS FOR NOT NEEDING A FEDERAL In order to demonstrate eligibili~ for one of the onsite treatment tiers,facilities are required to provide the basis for determining that a hazardous waste permit ix not required under the federal R~ource Conservation and Recovery Act (RCRA) and the federal regulations adopted under RCR~ (]Ttle 40, Code of Federal Regulations .(CFR)). Choose the rect~on(s) that describe the operation of your onMte treatment units: O I. The hazardous waste being treated is not a hazardous waste under federal law although it is t~,ulated as a hazardous ~ waste trader California state law. [-'1 2. The waste is treated in wastewater treatment units (Umk~), as defined in 40 CFR Part 260.10, and discharged to a publicly owned treatment works (PO'FW)/sewering agency or under an NPDES permit, 40 CFR 264. l(g)(6) and 4O CFR 270.2. DTSC 1772B (1/93) Page I0 CONDITi~)NALLY EXEMFr - SPECIFIED WASTESTREAMS .A~ co UNIT 5PF-CIFIC NOTIFICATION {pun'uant to Health and Safety Code Section 23201.$(c)) IV. BASIS FOR NOT NEEDING A FEDERAL PERMIT: {continued) ['=] 3. The waste is treated in elementary neutralization units, as defined in 40 CFR Part 260. IO, and discharged to POTW/sewering agency or under an NPDES permit. 40 CFR 264.1(g)(6) and 40 CFR 270.2. [-'] 4. The waste is treated in a to~ally enclosed treatment facility as defined in 40 CFR Part 260.10; 40 CFR 264. l(g)(5). [-'] 5. The company 'g~neratez no more than. 100 kg (approximately 27 gallons) of hazardous waste in a' calendar and is eligible as a federal conditionally exempt small quantity generator. 40 CFR 260. I0 and 40 CFR. 261.5. I'-'] 6. The waste is treated in an accumulation tank or container within 90 days for over 10(X) kg/month generators 180 or 270 days for generators of I00 to 1000 kg/month. 40 CFR 262.34, 40 CFR 270.1 (c}(2)(i), and the P~camb:c to the March 24, 1986 Federal Register. I~ 7. Recyclable materials are reclaimed to recover economically significant amounts of ailver or other precious metals. 40 CFR 261.6(a)(2}(iv), 40 CFR 264. l(g)(2), and 40 CFR 266.70. ['-] 8. Empty container rinsing and/or treatment. 40 CFR 261.7. F-] 9. Other:. specify: V. TRAaNSPORTABLE TREATMENT UNIT: Check Yes or No. Pleare refer to the btrtructionr for more informmion. YES NO ['-[ ' [~] Is this unit a Tr-zast~rtable Treatment Unit? ~ If you answered yes, you must also complete ahd attach Form 1772E to this page. \ ; The Tier-Spedfic Factsheets contain a summary, of the operating requirements for this eategor7. P1ease re?Jew those requirements carefully before completing or submitting this nofifienfi(~n package. DTSC 1772B (l/93) - Page ] X-RAY STORAGE 107 DARK ROOM 10 BAKERSFIELD ~ FAMILY .. ~k~ fl I~EDICA L i1~- CENTER 4580 California Avenue, Bakersfielc CA 93309 (805) 327-4411 ; March 30, 1993 Mr. Mike Homer Chief of Office On-Site Hazardous Waste Treatment Unit Post Office Box 806 Sacramento, CA 95812-0806 Dear Mr. Horner, We wish to provide the Department with our Conditionally Exempt Unit Specific Notification as it once applied to our silver r-ecovery units. We submit these unit specific notifications and our check for $100. for fees 1993. We'wi'll- assume that, unless we hear from you, we will qualify for' retroactive facility fee exemption for past years which we could have been subject to. We would also like to inform the department that we, as of 10/9/92, changed the method with which we process or photographic fix solutions as follows: (a) Processors, singularly or in groups, are coupled with Siltech 'F-IOOR Recycling Units. (b) While processing, spent x-rays fixer is transferred to the recycling machine for physical separation. A percentage of spent fixer (usually in excess 60%) is transferred back into the replenishment tanks for reuse. The balance (generally 40% or less) is hauled off for off-site treatment. (c) The recycling machines are inspected and serviced on a regular basis. All residues are cleaned to ensure quality of recycled fi.xer. (d) With these modifications to our unit's, closure was not needed. This above process falls in line with the HSC 25]43.2 (c) (2). Sincerely, -" Attachments: Facility Specific Notification Check for Fees Unit Specific Notification Plot Plan Map ST E F C LIFORNI:A--ENVIRO ME TAL PROTE - PETE WILSONi G&vernor DEPARTMENT OF TOXIC· SUBSTANCES; CONTROL 400 P Street, 4th Floor P.O. Box 806 Sacramento, CA' 95812-0806 " : :' · EPA'ID: CAD983617044 BAKERSFIELD FAMILY MEDICAL CENTER . For facility located at: DEAN WORK ' . 4580 CALIFORNIA AVENUE .. 4580 CALIFORNIA AVENUE BAKERSFIELD, CA 93309" BAKERSFIELD,, CA 93309 Authorization Date: 12/20/93 Dear Conditionally Authorized and/6r Conditionally Exempt Facility: ACKNOWLEDGEMENT OF UNITS OPERATING UNDER CONDITIONAL AUTHORIZATION AND/OR CONDITIONAL EXEMPTION The Department of Toxic Substances Control (DTSC) has received youi' facility specific notification (form DTSC 1772) and forms for Conditional Authorization and/or Conditional~ Exemption for Specified Wastestreams (form DTSC 1772B and/or 1772C). YOur notifications are administratively cOmplete, but have .not been reviewed for technical adequacy, A technical review of. your. nOtifications will be conducted when an inspection is performed. At any time, you may be inspected and will be subjbct to penalty if violations of laws or regulations are found. The Department acknowledges receipt of your completed notification for the treatment unit(s) listed on the last · page of this letter. These units operating under Conditional AUthorization or Conditional Exemption are authorized by California law without additional Department.action, pursuant to Health and Safety Code sections' 25200.3 and 25201.5. Your authorization to operate continues until you notify DTSC that you have stopped treating 'waste and have fully closed the unit(s). You will be charged anmml fees calculated on a calendar year basis for each year you operate and have not notified DTSC that' the units hage been closed. You must notify the DTSC 60 days before first treating hazardous wastes in any new unit. You must also notify the DTSC whenever any of the information you provided in these notifications changes. To revise information, mail a cover letter to the above address explaining the changes, attach only the pages Of your notification package that have changed, and re-sign and date at the signature space on page 3 of form 1772. Your status to operate under Conditional Authorization and/or Conditional Exemption is contingent upon the accuracy of information submitted by you in the notifications mentioned above, and your compliance with all applicable requirements in..the Health and Safety Code; Any misrepresentation or any failure to fully disclose all relevant facts shall render your authorization' to operate null and void. You are also required to Properly close any treatment unit. Additional guidance on closure will be issued and distributed to all authorized onsite facilities later this year. Page 2 EPA ID! CAD983617044 ,. If you have any questions regarding this letter, or have questions On operating requirements for your facilitj,' please contact the nearest DTSC regional office, or this office at the letterhead 'address or phone number, .: ." .~ ShI../~IY' Michael S. Homer, Chief Onsite Hazardous Waste Treatment unit Permit Streamlin!ng Branch HaZardous Waste Management Program Enclomre ,"" '"' ce: '-SUSAN LANEY DTSC REGION 1 SURVEILLANCE& ENFORCEMENT BR. 10151 CROYDON' WAY, SUITE 3 'SACRAMENTO, CA '95827. STEVE MCCALLEY KERN COUNTY ENVIRON. HEALTH SERVICES DEPT 2700 M STREET, SUITE 300. BAKERSFIELD, CA 93301 Page 3' · . .. ' "'EPA. ID: CAD983617044 ENCLOSURE 1 : " "~ /hdta auth°r/z~ to, operate at th/s/oau/o~.-' · UNDER coNDITIONAL AUTHoRIZAT!ON~ - UNDER CONDITIONAL EXEMPTION: .?