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Home My WebLink AboutBUSINESS PLAN FENCED PARI(ING AREA ISOLATION WARD DOG BATHING ROON i STOR~ / SX! D ! ! i FENCED I C~IN LI~ F~NCED ~ I I I I I I ~0 ~S I I I FENCED I RUNS I / ~ ~ I I ~ I I I I RUNS I/ ~ I I I I I DaU STO CE CAS IN & LAB. AR~ -- ' il I _J ' 'OFFICE JA,H. R00~ ~I0~ RECEPTION ROO~ L CHESTER AVENUE I _l ~I I -- I FACILI?¥ DIAORAM - BAKERSFIELD VETERINARY itOSPITAL~ 323 CHESTER AVENUE FENCED PARKING AREA l inc in'era tot T ISOLATION WARD DOG BATHING ROOM STOOGE SHED FENCED I CHAIN LINK F~NCED I DOG ~ DOG RUNS ~ ~ FENCED RUNS I I I I ~ ~ DOC I ' II RUNs I ] ~ PORT t, }~-- AUTOCLAVE ROOMI ~ ,~ ~.~~ ANI~L X-RAY ROOM A_ - ~RGERY . WARD COM --_.GAsPRESSEq [~O~,e ~~ ~ , " STORAGE ' . . ', ROOM ', SUPPLIES ~.~ IN & OUT LAB. TREATMENT AREA . [ ~ ~ ~A.H. TREATMENT BUSINESS OFFICE ~ DESK ROOM FACILITY DIAGRAM - BAKERSFIELD VETERINARY HOSPITAL, 323 CHESTER AVENUE (Not to Scale) CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd F]oor, Bakersfield, CA 93301 FACILITY NAME [~,~-O,s~lelt~ V~ec~t~ ~f ~SPECTION DATE % ZZ~O ADD,SS ~2~ C~e~et ~o-~ 0 PHONENO. FACILITY dONTACT fla. ~a~ ~ ~Z BUSINESS ID NO. 15-210- ~SPECTION TIME~~ ~ ~ NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~Routine [~ Combined [~ Joint Agency [~ Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand i'~ ,, , 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 Questions regarding this inspection? Please call us at (661 ) 326-3979 ~us~ness~Si~Respo~y BAKERSFIELD VETERINAR OSPITAL SiteID: 015-021-000741 Manager : ~~ BusPhone: (661) 327-4444 Location: 323 CHESTER AVE Map : 103 CommHaz : Low City : BAKERSFIELD Grid: 31C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title.~ Emergency Contact / Title DR .--m~.~ON3.S H .B~2[KS-'~'~,~'Y~;~ Z./~'~r,¢Y__LAURIE A BEAVER / Business Phone: (661) 327-4446x Business Phone: (661) 327-4444x 24-Hour Phone : (661) 8-Tfc~T~2~x~q~D~ ~ 24-Hour Phone : (661) 633-2232x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth '-- Contact : Phone: (661) 327-4444x MailAddr: 323 CHESTER AVE State: CA City : BAKERSFIELD Zip : 93301 Owner BAKERSFIELD VETERINARY HOSPITAL Phone: (661) 327-4444x Address : 323 CHESTER AVE State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: 1, ~' w n3/{, ~ /~.r/' ~7Do hereby certi~ ~ha~ ~ have rev~e~ved the a~ched hazardous: mate~als manage- merit plan any ~rm~ions ~nstimm a complsm and ~rr~ man- ~ement plan ~or my ~ac~lity. 1 07/15/2003 fi BAKERSFIELD VETERINAR OSPITAL SiteID: 015-021-000741 Fast Format = Notif./Evacuation/Medical Overall Site --Agency Notification 03/26/1999 FIRE DEPT - CALL 911. -- Employee Notif./Evacuation 10/29/1990 WORD OF MOUTH. OUR FACILITY IS NOT LARGE ENOUGH TO REQUIRE BELLS OR ALARMS. -- Public Notif./Evacuation 12/05/1996 WE DO NOT NOTIFY THE PUBLIC. ONE EMPLOYEE IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION OF OTHERS IS NECESSARY. Emergency Medical Plan 03/26/1999 ~c~ ~o~T~L - ~ T~UXT~ ~V~ - ~~O~ ~ ~ ~- ~ ~ ~ -5- 07/15/2003 BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 Manager : BusPhone: (661) 327-4444 Location: 323 CHESTER AVE Map : 103 CommHaz : Low City : BAKERSFIELD Grid: 31C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title DR THOMAS H BANKS / LAURIE A BEAVER / Business Phone: (661) 327-4446x Business Phone: (661) 327-4444x 24-Hour Phone : (661) 871-1623x 24-Hour Phone : (661) 633-2232x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact : Phone: (661) 327-4444x MailAddr: 323 CHESTER AVE State: CA City : BAKERSFIELD Zip : 93301 Owner BAKERSFIELD VETERINARY HOSPITAL Phone: (661) 327-4444x Address : 323 CHESTER AVE State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: + += Hazmat Inventory One Unified List + +== Alphabetical Order Ail Materials at Site + ................................ + ....... + ........... +- + -+ .... +- - -+ Hazmat Common Name;.. ISpeoHazlEPA HazardsI Frm I DailyMax IUnitlMCPI ................................ + ....... + ........... + ..... + .......... + .... +- - -+ NITROGEN F P IH G 228.00 FT3 Min OXYGEN F P IH G 1697.00 FT3 Low 1, ~.~z.~-J U~.,~,~ Do hereby ceri~i~y thru ~ havs gype or p~-t ~a~) reviewed ~h~ a~ached h~ardous materials manags- ment plan ~or ~,~ ~¢m~ffd thru ~t alo~ with (ga~ ~ Busine~) any corrections constitute a complete and correc~ man- agemem plan for my ~acili~. Sig~mre - 1 - 0 3 / 21 / 2 0 0 2 + BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 += Inventory Item 0002 Facility Unit: Fixed Containers on Site +== COMMON NAME / CHEMICAL NAME --+ NITROGEN I Days On Site 365 Location within this Facility Unit Map: Grid: + ................ SURGERY RM I CAS# 7727-37-9 +---_ ==+===== += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+ .... CONTAINER TYPE I Gas I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER 4 + AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 228.00 FT3 228.00 FT3 228.00 FT3 4 ~ HAZARDOUS COMPONENTS +===~ 100.00 Nitrogen No 7727379 + ........ ~ +===~ ~ ~===4 ~ HAZARD ASSESSMENTS ===~ -=4 +===== ITSecretl RSIBioHazl Radioactive/Amount ] EPA Hazards NFPA I USDOT# I MCP No No No No/ Curies F P IH / / / Min ~ +===4 ~ =+ ~ ~ ~=====+ += Inventory Item 0001 Facility Unit: Fixed Containers on Site +== COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: + ................ S WALL OF LAUNDRY RM/SURGERY RM SE CORNER CAS# 7782 -44-7 += STATE =+= TYPE ===+== PRESSURE ===+ TEMPEHATURE ==+ .... CONTAINER TYPE I Gas I Pure I Above Ambient I Ambient 4 ~ += ~ ~ =+ 4 + AMOUNTS AT THIS LOCATION =+ Largest Container Daily Maximum Daily Average 1697.00 FT3 1697.00 FT3 1697.00 FT3 4 ~--- HAZARDOUS COMPONENTS ~===+ .... %Wt. RS 100.00 Oxygen, Compressed No 7782447 + =+-- ~===+----_ +-- ..... =+===+ ~ HAZARD ASSESSMENTS ===~ + ~===== ITSecretl RSIBioHazI Radioactive/Amount EPA Hazards NFPA I USDOT# I MCP No No No No/ Curies F P IH / / / Low + +===+ ~ ~= ~ ~ ~=====+ -2- 03/21/2002 + BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ Fast Format += Notif./Evacuation/Medical == Overall Site +== Agency Notification 03/26/1999 FIRE DEPT - CALL 911. +=== Employee Notif./Evacuation . 10/29/1990 WORD OF MOUTH. OUR FACILITY IS NOT LARGE ENOUGH TO REQUIRE BELLS OR ALARMS. + .... Public Notif./Evacuation 12/05/1996 WE DO NOT NOTIFY THE PUBLIC. ONE EMPLOYEE IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION OF OTHERS IS NECESSARY. += + ..... Emergency Medical Plan 03/26/1999 MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 OR DR EDWARD P BROWN - 2531 G ST - 327-7348. += 3 03/21/2002 + BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 + Fast Format += Mitigation/Prevent/Abatemt Overall Site +== Release Prevention 10/29/1990 CYLINDERS PROPERLY CHAINED, PROPER VALVES & FITTINGS. += +=== Release Containment - 10/29/1990 WE STORE ONLY OXYGEN AND NITROGEN. IF RELEASE IN A CONFINED SPACE, WE AREATE THE BUILDING TO PREVENT HAZARD TO ITS OCCUPANTS. + .... Clean Up 10/29/1990 NO SPECIAL MATERIALS OR EQUIPMENT IS NECESSARY FOR OXYGEN AND NITROGEN. + ..... Other Resource Activation -4- 03/21/2002 + BAKERSFIELD VETERINARY HOSPITAL = SiteID: 015-021-000741 + += Fast Format + += Site Emergency Factors = Overall Site + +== Special Hazards == 03/26/1999 + BIG MEAN DOGS IN REAR OF COMPOUND. += + +=== Utility Shut-Offs 03/26/1999 + A) GAS - S SIDE BLDG, 6 FT W OF CENTER DOOR B) ELECTRICAL - N SIDE OF BLDG ON E CORNER OF CAR PORT C) WATER - W SIDE OF BLDG IN S FLOWER BED D) SPECIAL - NONE E) LOCK BOX - NO + .... Fire Protec./Avail. Water 03/26/1999 + PRIVATE FIRE PROTECTION - WE HAVE ABC TYPE FIRE EXTINGUISHERS FOR USE BY OUR EMPLOYEES IN FIGHTING FIRE IF IT IS SAFE TO DO SO. FIRE HYDRANT - WE ARE BETWEEN TWO FIRE HYDRANTS - BOTH OF WHICH ARE APPROXIMATELY 325 FT FROM THE BLDG. 1 ON THE NW CORNER OF THIRD AND CHESTER; 1 ON THE SW CORNER OF INTERSECTION OF FOURTH AND CHESTER. + + ..... Building Occupancy Level --- -5- 03/21/2002 + BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ Fast Format += Training Overall Site +== Employee Training 03/26/1999 WE HAVE 15 EMPLOYEES AT THIS FACILITY (NEVER ALL HERE AT THE SAME TIME). WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: WRITTEN INSTRUCTION. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, EVACUATION, ETC. POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. + = +=== Page 2 = + : + .... Held for Future Use --~ + ..... Held for Future Use -6- 03/21/2002 BAKERSFIELD VETERINARY HOSPITAL~ Ii~C~VEDI SiteID: 215-000-000741 I MAR '~ 5 1999 | Manager : ~/-' .J Bus,hone: (805) 327-4444 Location: 323 CHESTER AVE '~[~--~' Map/: 103 CommHaz : Low City : BAKERSFIELD ~ ..... ~r~: 31C FacUnits: 1 AOV: CommCode: B~ERSFIELD STATION 06 SIC Code: EPA Nu~: DunnBrad: Emergency Contact / Title Emergency Contact / Title DR THOMAS H BANKS / LAURIE A BEAVER / Business Phone: (805) 327-4446x Business Phone: (805) 327-4444x 24-Hour Phone : (805) 871-1623x 24-Hour Phone : (805) 633-2232x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact : Phone: ( ) - x MailAddr: 323 CHESTER AVE State: CA City : BAKERSFIELD Zip : 93301 Owner BAKERSFIELD VETERINARY HOSPITAL Phone: (805) 327-4444x Address : 323 CHESTER AVE State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: = Hazmat Inventory One Unified List -- As Designated Order Ail Materials at Site Hazmat Common Name... ISpocHazlEPA HazardsI Frm I DailyMax Unit MCP OXYGEN F P IH G 1697 FT3 Low NITROGEN / F P IH G 228 FT3 Min ~,- /,~o,',~-~ ~,~,,,~ Do hereby c~nify ~hatlhave reviewed ~he a~ached h~ardous materials manage- mere plan for~~ ~~ ~nd t~t i~ along wi~h any corre~ions cons~i~u~s a ~mple[e and ~e~ man- agement p~sn for my ~. -z- o~/oz/z~ BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: S WALL OF LAUNDRY ROOM SURGERY ROOM SOUTHEAST CORNER OR AUTO CAS# 7782-44-7 Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average FT3I 1697.00 FT3 1697.00 FT3 HAZARDOUS COMPONENTS 100.00 Oxygen, Compressed N 7782447 HAZARD ASSESSMENTS TSecretI ~SIBioHazI Radioactive/Amount I EPA HazardsI NFPA USDOT# MOP No N No No/ Curies F P IH / / / Low ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~...:%21V. llVlUl%l J.%l.-'-.U.Vl~''. / ~..:l-J.~51Vl.L %..:Z-.~.L~ JN2'-U.vI~., NITROGEN Days On Site 365 Location within this Facility Unit Map: Grid: SURGERY ROOM CAS# 7727-37-9 Gas /Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average FT3 228.00 FT3 228.00 FT3 HAZARDOUS COMPONENTS 100.00 Nitrogen N 7727379 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F P IH / / / Min 2 03/01/1999 BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 Fast Format F Notif./Evacuation/Medical Overall Site Agency Notification 10/29/1990 FIRE DEPARTMENT - CALL 911 Employee Notif./Evacuation 10/29/1990 WORD OF MOUTH. OUR FACILITY IS NOT LARGE ENOUGH TO REQUIRE BELLS OR ALARMS. Public Notif./Evacuation 12/05/1996 WE DO NOT NOTIFY THE PUBLIC. ONE EMPLOYEE IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION OF OTHERS IS NECESSARY. Emergency Medical Plan 10/29/1990 MERCY HOSPITAL DR. EDWARD P. BROWN 2215 TRUXTUN AVE 2531 G STREET i (805) 327-3371 (805) 327-7348 -3- 03/01/1999 F BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 10/29/1990 CYLINDERS PROPERLY CHAINED, PROPER VALVES & FITTINGS. -- Release Containment 10/29/1990 WE STORE ONLY OXYGEN AND NITROGEN. IF RELEASE IN A CONFINED SPACE, WE AREATE THE BUILDING TO PREVENT HAZARD TO ITS OCCUPANTS. -- Clean Up 10/29/1990 NO SPECIAL MATERIALS OR EQUIPMENT IS NECESSARY FOR OXYGEN AND NITROGEN. Other Resource Activation -4- 03/01/1999 BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 Fast Format ~ Site Emergency Factors Overall Site -- Special Hazards 10/29/1990 BIG MEAN DOGS IN REAR OF COMPOUND --Utility Shut-Offs 10/29/1990 A) GAS - SOUTH SIDE BUILDING, 6 FT WEST OF CENTER DOOR B) ELECTRICAL - NORTH SIDE OF BUILDING ON EAST CORNER OF CAR PORT C) WATER - WEST SIDE OF BUILDING IN SOUTH FLOWER BED D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 10/29/1990 PRIVATE FIRE PROTECTION - WE HAVE ABC TYPE FIRE EXTINGUISHERS FOR USE BY OUR EMPLOYEES IN FIGHTING FIRE IF IT IS SAFE TO DO SO. FIRE HYDRANT - WE ARE BETWWEN TWO FIRE HYDRANT - BOTH OF WHICH ARE APPROXIMATELY 325 FEET FROM THE BUILDING. 1 ON THE NORTWEST CORNER OF THIRD AND CHESTER; 1 ON THE SOUTHWEST CORNER OF INTERSECTION OF FOURTH AND Building Occupancy Level -5- 03/01/1999 BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 Fast Format = Training Overall Site -- Employee Training 10/29/1990 WE HAVE 15 EMPLOYEES AT THIS FACILITY (NEVER ALL HERE AT THE SAME TIME) WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: WRITTEN INSTRUCTION. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, EVACUATION, ETC. POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. Page 2 Held f°r Future Use Held for Future Use -6- 03/01/1999 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ........ ,~,~,,~?.?~:?:~??,::??~,~:,~, ......... This permit is issued for the following: ..... Materials Plan .,~:.=:F ~[~!=:.~..~. =~:..~:===~:.=..-, ,.~!..,!,. ~i'~:'.';,~,:Z[':?~.di[F~iiii:~:~=-- ......... 'q~,:, .. -. '"" BAKERSFIELD VETERINARY . :~ '~:~' ~ .... ~::~::.~:~ ................ ~.,-- .'~ ',~':,l, ~: ..4 '-, ~ ~ ~'.Z~ ii~, ',. '~J]' "::~H~;b:,~"...,' .:" ..': :," ..'= ,-' .." ,:' ,' ? .~' ~' ~L~b Is~ by: O B~er*field Fke D~a~ent Approved by: ~~~' O~CE OF E~RON~AL S~ ~CES ~ph Huey~ 1715 Chewer Ave., 3rd Floor Office of ~enmi B~e~fiel~ CA 9~301 Voice (805) 32~3979 F~ (80S)~2b-0S76 Expiration Date: ~n~ ~O~ ~OOO maT.~--_~-~=~=~_--=~ SiteID: 215-000-000741 + BAKERSFIELD VETERINARy Operator: ~{ /~/iSusPhone: (805) 327-4444 OvrlHaz Low Location: 323 CHESTER AV ~ DEC &199~ l~!Map : 103 : city : BAKERSFIELD <~,,/~ ~iGrid: 31C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATI(~b .......... r:~_3SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title DR THOMAS H BANKS / LAURIE A BEAVER / Business Phone: (805) 327-4446x Business Phone: (805)~~327-4444x 24-Hour PHone : (805) 871-1623x 24-Hour PHone Pager Phone : ( ) - x Pager Phone : ( ) - x | Hazmat Hazards: Fire Press ImmHlth Contact : Phone: ( ) - x MailAddr: 323 CHESTER AV State: CA City : BAKERSFIELD Zip : 93301 Owner : BAKERSFIELD VETERINARY HOSPITAL Phone: (805) 327-4444x Address : 323 CHESTER AV State: CA City : BAKERSFIELD Zip : 93301 --+ Period : 'to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: EHSs: No First Response Directives: BIG MEAN DOGS IN REAR COMPOUND += Hazmat Inventory One Unified List +== MCP+DailyMax Order All Materials at Site ~ + + ~ ~ .... +___+ Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax lUnitlMCPI +__ } + + ! ~ .... +___+ OXYGEN F P IH G 1697 FT3 Low NITROGEN F P IH G 228 FT3 Min Do hereby certify that I have (Type or print name) ~viewed the a~ached hazardous materials manage- nent plan ~or~_.and that it along with my corrections constitute a complete and correct man- tgement plan for my fac~,ty. ',.' (u,/ {_,~/~:~gnamre : Date" ' + BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 += Inventory Item 0001 Facility Unit: Fixed Containers on Site +== COMMON NAME / CHEMICAL NAME += Days On Site =+ OXYGEN I 365 Location within this Facility Unit I CAS# S WALL OF LAUNDRY ROOM SURGERY ROOM SOUTHEAST CORNER OR AUTOI 7782-44-7 +_= .... + += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+ .... CONTAINER TYPE I Gas I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER + ......... +====== .... 4 ~ .... 4 + ........ AMOUNTS STORED AND IN USE I Lrgst C°nt'this L°c FT3 I DailyMax this L°c FT3 ] DailyAvg this L°c FT3 11697.00 1697.00 + .............. ~============= ~ ......................... + ....... + .............. HAZARDOUS COMPONENTS +===4 100.00 Oxygen, Compressed No 7782447 + ....... + ................ :::::::::::::::::::::::: ..... ==========+ + ....... +===4 ~====== .... = HAZARD ASSESSMENTS ===+ ......... +-- +=====+ 8TSecretlEHSlBi°HazINo No No Radioactive/Amount No/ Curies FEPAp HazardsIIH NFPA/// I USDOT# / MCP UFC Article 80 Control Zone: USDOT Hazards In Cabinet? Sprinklered Area? + ......... MISC. LOCAL AGENCY DATA ..... ==+ Ag. Definedl: Ag. Defined2: Ag. Defined3: Ag. Defined4: Ag. Defined5: Ag. Defined6: Ag. Defined7: Ag. DefinedS: Ag. Defined9: Ag.definel0: +- Ag. Definell ~ -2- + BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 += Inventory Item 0002 Facility Unit: Fixed Containers on Site +== COMMON NAME / CHEMICAL NAME ........ += Days On Site =+ NITROGEN I 365 Location within this Facility Unit I CAS# SURGERY ROOM I 7727-37-9 + .................... 4 ........... += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+ .... CONTAINER TYPE I Gas I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER + ......... + .... ======+ .......... =====4 % + ......... AMOUNTS STORED AND IN USE I Lrgst C°nt'this L°c FT3 I DailyMax this L°c FT3 I DailyAvg this L°c FT3 1228-.00 228.00 + + --+ I DailyMax Stored FT3 I DailyMax Open Use FT3 I DailyMax Closed Use FT3 + ....... ~ ............. + ................. + ....... + .............. HAZARDOUS COMPONENTS ........ +===+ ............... 100.00 Nitro~en No 7727379 + ....... +=~+ ...... + ........... HAZARD ASSESSMENTS ~+ ......... ~ + ..... UFC Article 80 Control Zone: USDOT Hazards In Cabinet? Sprinklered Area? + ......... 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 ---+ 3 BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 ........ Fast Format += Notif./Evacuation/Medical Overall Site +== Agency Notification 10/29/1990 FIRE DEPARTMENT - CALL 911 +=== Employee Notif./Evacuation 10/29/1990 I WORD OF MOUTH. OUR FACILITY IS NOT LARGE ENOUGH TO REQUIRE BELLS OR ALARMS. I .... Public Notif./Evacuation 10/29/1990 WE DO NOT NOTIFY THE PUBLIC. ONE EMPLOYEE IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION OF OTHERS INS NECESSARY. Emergency Medical Plan 10/29/1990 MERCY HOSPITAL DR. EDWARD P. BROWN 2215 TRUXTUN AVE 2531 G STREET (805) 327-3371 (805) 327-7348 -4- BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 ........ Fast Format += Mitigation/Prevent/Abatemt Overall Site +== Release Prevention 10/29/1990 PROPERLY CHAINED, PROPER VALVES & FITTINGS. CYLINDERS +=== Release Containment 10/29/1990 WE STORE ONLY OXYGEN AND NITROGEN. IF RELEASE IN A CONFINED SPACE, WE AREATE THE BUILDING TO PREVENT HAZARD TO ITS OCCUPANTS. + .... Clean Up 10/29/1990 + I NO SPECIAL MATERIALS OR IS NECESSARY FOR OXYGEN AND NITROGEN. EQUIPMENT Other Resource Activation ....... -5- + BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 + ............. Fast Format += Site Emergency Factors Overall Site +== Special Hazards 10/29/1990 BIG MEAN DOGS IN REAR OF COMPOUND +=== Utility Shut-Offs 10/29/1990 A) GAS - SOUTH SIDE BUILDING, 6 FT WEST OF CENTER DOOR B) ELECTRICAL - NORTH SIDE OF BUILDING ON EAST CORNER OF CAR PORT C) WATER - WEST SIDE OF BUILDING IN SOUTH FLOWER BED D) SPECIAL - NONE E) LOCK BOX - NO + .... Fire Protec./Avail. Water 10/29/1990 PRIVATE FIRE PROTECTION - WE HAVE ABC TYPE FIRE EXTINGUISHERS FOR USE BY OUR EMPLOYEES IN FIGHTING FIRE IF IT IS SAFE TO DO SO. FIRE HYDRANT - WE ARE BETWWEN TWO FIRE HYDRANT - BOTH OF WHICH ARE APPROXIMATELY 325 FEET FROM THE BUILDING. 1 ON THE NORTWEST CORNER OF THIRD AND CHESTER; 1 ON THE SOUTHWEST CORNER OF INTERSECTION OF FOURTH AND CHESTER. + ..... Building Occupancy Level -6- + BAKERSFIELD VETERINARY HOSPITAL SiteID: 215-000-000741 + + .............. Fast Format + += Training Overall Site + +== Employee Training 10/29/1990 + WE HAVE 15 EMPLOYEES AT THIS FACILITY (NEVER ALL HERE AT THE SAME TIME) WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: WRITTEN INSTRUCTION. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, EVACUATION, ETC. POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. +=== Page 2 .......... + -7- 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000741 Page 1 Overall Site with 1 Fac. Unit General Information Location: 323 CHESTER AV Map: 103 Hazard: Low Community: BAKERSFIELD STATION 06 Grid: 31C F/U: 1 AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone- LAURIE A BEAVER (805) 327-4444 x (805) 873-7606 Administrative Data Mail Addrs: 323 CHESTER AV D&B Number: City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: Owner: BAKERSFIELD VETERINARY HOSPITAL Phone: (805) '327-4444 Address: 323 CHESTER AV State: CA City: BAKERSFIELD Zip: 93301- Summary RECEIVED BIG MEAN DOGS IN REAR COMPOUND HA~. MAT. DIV. I, ~ry,.o,p,.,~,.,.) DO hereby certify that I have reviewed the attached hazardOus materials manage- for-~.~,.,~, ~,.~ ~/~. ment plan (,=~o,,~,~o~,~ and that it along with any corrections constitute a complete and correct man- agement plan for my facility. 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000741. Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-001 OXYGEN Gas 1697 Low ~ Fire, Pressure, Immed Hlth FT3 02-002 NITROGEN Gas 228 Minimal ~ Fire, Pressure, Immed Hlth FT3 .~ 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000741 Page 3 02 - Fixed Containers on Site HaZmat Inventory Detail in MCP Order 02-001 OXYGEN Gas 1697 Low ~ Fire, Pressure, Immed Hlth FT3~ CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3 Daily Average FT3 --~ Annual Amount FT3 1,697 I ' 1,697.00 21,980.00 Storage Press T Temp ~ Location PORT. PRESS. CYLINDER Above ~AmbientI S WALL OF LAUNDRY ROOM · PORT. PRESS. CYLINDER Above JAmbient SURGERY ROOM PORT. PRESS. CYLINDER Above ~Ambient SOUTHEAST CORNER OR AUTOCLAVE RO -- Conc Components Guide 100.0% IOxygen, Compressed ILo~cP 14 02-002 NITROGEN Gas 228 Minimal ~ Fire, Pressure, Immed Hlth FT3 CAS #: 7727-37-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3I Daily Average FT3 I ~ Annual Amount FT3 228 ~ 228.00 284.00 Storage Press T Temp~ Location PORT. PRESS. CYLINDER Above ~AmbientlSURGERY ROOM -- Conc Components MCP ---q4~uide 100.0% INitrogen ILow ~ 21 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000741 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification FIRE DEPARTMENT - CALL 911 <2> Employee Notif./Evacuation WORD OF MOUTH. OUR FACILITY IS NOT LARGE ENOUGH TO REQUIRE BELLS OR'ALARMS. <3> Public Notif./Evacuation .WE DO NOT NOTIFY THE PUBLIC. ONE EMPLOYEE IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION OF OTHERS INS NECESSARY. <4> Emergency Medical Plan MERCY HOSPITAL DR. EDWARD P. BROWN 2215 TRUXTUN AVE 2531G STREET (805) 327-3371 (805) 327-7348 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000741 Page 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention CYLINDERS PROPERLY CHAINED, PROPER VALVES & FITTINGS. <2> Release Containment WE STORE ONLY OXYGEN AND NITROGEN. IF RELEASE IN A CONFINED SPACE, WE AREATE THE BUILDING TO PREVENT HAZARD TO ITS OCCUPANTS. <3> Clean Up NO SPECIAL MATERIALS OR EQUIPMENT IS NECESSARY FOR OXYGEN AND NITROGEN. <4> Other Resource Activation 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000741 Page .'6 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards BIG MEAN DOGS IN REAR OF COMPOUND <2> Utility Shut-Offs A) GAS - SOUTH SIDE BUILDING, 6 FT WEST OF CENTER DOOR B) ELECTRICAL - NORTH SIDE OF BUILDING ON EAST CORNER OF CAR PORT C) WATER - WEST SIDE OF BUILDING IN SOUTH FLOWER BED D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - WE HAVE ABC TYPE FIRE EXTINGUISHERS FOR USE BY OUR EMPLOYEES IN FIGHTING FIRE IF IT IS SAFE TO DO SO. FIRE HYDRANT - WE ARE BETWWEN TWO FIRE HYDRANT - BOTH OF WHICH ARE APPROXIMATELY 325 FEET FROM THE BUILDING. 1 ON THE NORTWEST CORNER OF THIRD AND CHESTER; 1 ON THE SOUTHWEST CORNER OF INTERSECTION OF FOURTH AND CHESTER. <4> Building Occupancy Level 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000741 page 7 00 - Overall Site <G> .Training <1> Page 1 WE HAVE 15 EMPLOYEES AT THIS FACILITY (NEVER ALL HERE AT THE SAME TIME) WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: WRITTEN INSTRUCTION. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, EVACUATION, ETC. POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. <2> Page 2 as needed <3> Held for Future Use ~ <4> Held for Future Use O~/27/90 BAKERSFIELD VETERINARY HOSPITAL 215-OOO-OOO741 Overall Site with 1 Fac. Unit 0:~T 16 General Information Locatior~: 323 CHESTER AV Map: 103 Hazard: Low Ident Number: 215-000-000741 Grid: 31C Area of Vul: 0.0 Contact Narne Title ,I : Busir~ess Phc, r~e ~ ~4 Hc, u~ Phone] DR. THOMAS H. BANKS I (805) 327-4446 x 805) 871-1623[ LAURIE A..~' ~(805) 327-4444 x 805) 87~7~ Administrative Data Mail Addrs: 323 CHESTER AV D&B Number: City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: Owner: - ~T~.~ ~~ ROSPI~, ~. Phc, r~e: ( ~5 ) - '~ ' :' State: CA Address: --323 ~ste~ A~ .... C i t y: ~:~ ~s~i~l~ -- "- Z i p: 93~1 Summary BIG MEAN DOGS IN REAR COMPOUND , ~"~ rr~;,~ Do ~ereby certify that l~ mentrevieWedplan the attached h~z'ar'do~.~: ,materials manage.. ~~;~,,.?k.,, ,,..~,, that., it along ~ith any corre~ions constitute a complale arid corre~ ma-: sgsment plan for my .,,,,[y 08/27/90 BAKERSFIELD VETERINARY HOSPITAL 21~5-0 -000741 Page 2 Hazrnat Ir, vet, tory List in Referer, ce Nuraber Order (>2 - Fixed Cot, fair, ers or, Site Plr,-Ref Name/Hazards Form Quantity MCP 02-001 OXYGEN ~l~der$ ? 1,49~ Low FT3 02-002 NITROGEN ~l~der ? 228 Mimimal FT3 FT3 02-004 OXYGEN 6~li~der ? 154 Low FT3 02-005 OXYGEN 6~li~der ? 44 Low FT3 FT3 We no longer use Nitrous Oxide ·o 08/2?/90 BAKERSFIELD VETERINARY HOSPITAL 215-0c)0-000741 Page 3 O0 - Overall Site <D> Notif. /Evacuation/Medical <1> Agency Notification FiRE DEPAR~If - DIAL 911 <2> Employee Notif. /Evacuatior, Word of Mouth. O~r facility is not large enough to require bells or alams. <3> Public Notif. /Evacuatior, We do not notify the public. One employee is designated to ask the Senior Fireman present if notification of others is necessary. <4> Emergency Medical Plat, I~IRCYHOSPITAL 2215TRUXTUNAV~NRIE 327-3371 2531 G Street 327-7348 08/27/90 BAKERSFIELD VETERINARY HOSPITAL 21 -000741 Page 4 O0 - Overall Site <E> Mit igat ior,/Prever, t/Abatemt <1> Release Prever, tior, CYLINDERS PROPERLY CHAINED, PROPER VALVES & FITTINGS. <2> Release Containment ~ store only Oxygen and Nitrogen. If released in a confined space, we areate the building to prevent hazard to its occupants. <3> Clear, Up No special materials or equitm~nt is necessary for Oxygen and Nitrogen. <4> Other Resource Act i vat i or, BAKERSFIELD VETERINARY HOSPITAL 215-000-000741 Page 5 O0 - Overall Site <F> Site Emerger, cy Factors <1> Special Hazards BIG MEAN DOGS IN REAR OF COMPOUND <2> Utility Shut-Offs A) GAS - SOUTH SIDE BUILDING, 6 FT WEST OF CENTER DOOR B) ELECTRICAL - NORTH SIDE OF BUILDING ON EAST CORNER OF CAR PORT C> WATER - WEST SIDE OF BUILDING IN SOUTH FLOWER BED D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - ????????????? We have "ABC" type fire eztinguishers for use by our employees in fighting fire if it is safe to do so. FIRE HYDRANT - ?????????????? We are between two fire , hydrants ~ - beth of which are approximately 325 feet from the building. ~thw~st corner of Third street and ~Chester.~ AVenue! 2. Southwest Comer of intersection of FOJR~H Street <4> Held for Future use Chester Avenue. 0.8~27/90 BAKERSFIELD VETERINARY HOSPITAL 215-0 -000741 Page 6 O0 - Overall Site <G> Training <1> Page 1 WE HAVE ? ? EMPLOYEES AT TH I S FAC I L I TY 15 ~mploye~$ - N~r all h~re at tile s~ tim~. DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? ¥e$. BRIEF SUMMARY OF TRAINING: 1. Written Instructions. 2. Orientation on location of extinguishers, cylinders, evacuation rroutes, evacuation, .etc. 3. ~os,~ed:,Fire Plans and '~azardous Materials'~ i.~formation. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use CII'Y of BAKERSFIELD HAZARDOUS MATERIALS INVENTORY Fare and Agriculture FI Standard Business [] NON--TRADE SECRETS Page I of ~ BUSINESS NAME: BAKERSFIFL? VETERINARY HOSPITAL, I~WNER NAME: BAKERSFIELD VETERINARY HOSPITAL, I~AME OF THIS FACILITY: CHESTER AVENUE HOSPITAL LOCATION; '37~ Cheerer Avem,e .... ADDRESS: 37~ Ch~+~r Aven,,P =~. STANDARD IND. CLASS CODE[ CIIY. ZIP~ R~r~+i~ld. m.l;forn;m 93~1 ~,~. lIP! R~E~;~IH. nml;~nn~;~ g~ .... DUN AND BRADSTREE; ~U~B~R ................ PHONE fl: - (~'~ ~'-~444 __ ~Hum ~: - ' ......... ' REFE~ TO~~O~ZONS~R-PROPER CODES .... ~ 77-0040414 I 2 3 4 5 6 I 8 9 l0 II 12/3 Trans Code ~oee Ami AmC Est Un~ts on~ype Press Temo CoueStored ~n ~acl~Cy See Instructions Physical and Health Hazard C,A,S. Number 7782-44-7 Component I1 Name I C.A.S. Number (Chec[ all that apply) Component 12 Name I C.A.S. Number ireHazard ~ Reactivity ~ Delayed ~SuddenRelease ~ImmediaLe ~ Co~ponent 13 Name I C.A.S. Number Health of Pressure Health Physical and Health Hazard C.A.S. Number 7782-44-7 Component II Name I C.A.S. Number (Check ali that apply) Co=p~,'~1 C.A.S. Number ~xFire Hazard 0 Reactivity 0 Delayed ~Suddefl Release ~Immediate Health of Pressure He~~'' l.S. Number U I P ] 228 I 228 I 284 ~ FT, ~-~ ~XSY R~O~ NITROGEN , Physical and Health' Hazard C.A,5. Number ~, Number (Check all that apply) 0 Fire Hazard 0 Reactivity 00elayedHeaiCh ~Su~ ~ ' ~umber~ber tPhysical and Health Hazard ' C.A.L Number 7', (Check a11 that apply) ~XFire Hazard ~ Reactivity ~ Oelayed ~Sudden Release Health of Pressure ...a. Number EHERGENCY CONTACTS fll DR. T. H. BANKS PRES'IDENT ( fl2 L. A. BEAVER, A.H.T. Sr. A.H.T. (805) 87~-7606 Name ~C~ rn~ Raie Tltle ertifiatioq ,(Re~d and.~ign after compl~Ci~g.~ .~cti~nq) cer[~ty under pena~t~ ot~aF thq[ t navegersonal~Y.examln4oaqo~m tami~t[ .e[t~ the intotmat,on ~u~mittfd in this.~nd all at~acned.dqcgments, anO t~at oaseo on.my ~nquiry gt. cnose tmvma~s responsio/e tor obtaining the tntormac~on. [ he,mere that the ' WILFRED G. OWEN, BUSINESS MANAGER ' Oct 1, 1990 N~,.e e~ ~fi~iH title of o~A~rlooerator uN o~ner/operacot's authorized representative ~t9~4t~ .. CITY of BAKERSFIELD FiRE DEPARTMENT O.~.q NEEDHAM FIRE CHIEF September 4~ 1990 Dr. Thomas A. Banks Bakersfield Veterinary Inc. 323 Chester Avenue Bakersfield, Ca. 93301 Dear Dr. Banks: Enclosed you will find a computer printout o~ the Hazardous' Materials Management Plan that is currently in our computer, we have highlighted the areas that need to be revised. Also due to a change in the law that went into effect Januaryt 1989~ we need to have a new inventory form (enclosed) filled out. These forms must be filled out and returned to our office by September 28~ 1990. If you have any questions please don't hesitate to contact u~ at (805) 326-3979. Sincerely Yours~ Ralph E. Huey Hazardous Materials Coordinator REH:vp Enclosures SITE MAP - BAKERSFIELD VETERINARY HOSPITAL~ INC. 323 CHESTER AVENUE (Not' to Scale) 7~I Z/I,~/~ · ', 2~30 "G" STREET BAKERSFIELD,(805) 326-3979CA 9330b~ O~[C[A~ US~ ONlY BUSINESS HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A -. 0 INSTRUCTIONS: 1. To avoid further action, return this form by 2, TYPE/PRiNT ANSWERS I~ ENGLISH. RECEIVED 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. AU~ 1 3 1987 SECTION 1: BusINEss IDENTIFICATION DATA Ans'd ............ A. BUSINESS NAME: BAKERgFIF. I.D VF. TF. RTNARY unSPTTAI,~ TNC_ B. r,0CATION / STRr~ET ADDR£SS: ~.3~ /7_J~-_~$~C CITY: Bakersfield CA ZIP{.~9330~ BUS.PHONE: ( 805 ) 327.-441,4 '. SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency tnvolvlng the release or threatened release of a hazardous material, call 911 and li800-852-7550 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: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A. DR. THOMAS H. BANKS ' ~Ph# 327-4446 Ph~ 87~-1623 B. LAURIE A. ADR%A~CE~ A.H.T. Ph# 327-a4&4 Ph# SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A NHOLE A. NAT. GAS/PROPANE: ROTTT~ ~T~ ~F RITTT.~TM~ APPR~YTMA~T.¥ ~ ~ ':7~t ~ B. ELECTRICAL: NORTH SIDE OF BUILDING.ON EAST DORNER OF CAR PO~. -- C. WATER: WEST SIDE OF BUILDING IN SOUTH FLOWER ~gD. D. SPECIAL: ~ - E. LOCK BOX: YES ,(NO) IF YES, LOCATION: N/A IF YES, DOES IT CONTAIN SITE PLANS? YES /~) MSDSS? YES FLOOR PLANS? YE~.~) KEYS? YES, SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE _ None SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE .... ~C'~-{ ;~ ~.~ M:ercy Hospital Emergency room & Call: Edward P. Brown, M.D. 2215 Truxtun Avenue Tel: 327-7348 Bakersfield, CA 93301 2531 G Street Bakersfield, CA 93301 SECTION6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS: ....................................... YES fNO5 YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES ~_~ YES NO C. PROPER USE OF SAFETY EQUIPMENT:.' ................. YES~ YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. YES YES NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES YES NO SECTION ?: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ,MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... ~ NO I, THOMAS H. BANMS. D.V,M- , certify that the above information is accurate. I understand that ~hls information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. SIGNATU ~ _" ' TITLE President '~ATE July 15, 1987 KERN COUNTY FiRE DEPARTMENT I.D. · FORM 4A-I page~ of~ NON--TRADE SECRETS HAZARDOUS MATER'{' ALS INVENTORY BUSINESS NAME:BAKERSFIELD VETERINARY HOSPITAL,INC~WNER NAME: Thomas H. Banks~ DVM~ President FACILIT~ UNIT ·: ADDRESS: ~?~ C.b~v Avm~]le ADDRESS: 6220 Alfred Harrel Hwy. FACILITY UNIT NAME: CITY, ZIP: Bakersfield~ CA 93301 CITY,ZIp:Bakersfield, CA 93308 PHONE ·:..(805)327-4444 PHONE ·: (805)871-1623 {OFFICIAL USE CFIRS CODE ,ONLY 1 2 3 4 5 6 ? 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN ,THIS · BY HAZARD 0.0.T CODE AMOUNT AMOUNT UNIT CODE CODE ,FACILITY, UNIT WT. CHEMICAL OR COMMON NAME ,CODE GUIDE Southern Wall of P 1,499 20,000 FT3 4 27 Laundry Room -- Oxygen ~Sq OXID ~ 228 284 FT3 4 27 Surgery -- Nitrogen ~d NFLG ~) ~--~ ~',.~/ ~'~-'~ South Side of ~ i _P ~ 4 27 Laundry Room -- Nitrous Oxide ~3~ 5 NFLG I South East Corner of .. P 154 1,540 FT3 4 27 Au~oc. lmvo Room -- 0~ygen ~~ OXID _5~_ P 44 440 FT3 4 27 Surgery -- Oxygen ~ ~ 9 OXID p ~ ~r ~ 4 27 Surgery. -- Nitrous Oxide ~ ~-~ NFLG NAME: ~ILFRED G.OWEN TITLE: BUS. OFF .MGR. SIGNATURE: - DATE: 7-12 .87 EMERGENCY CONTACT: DR. T.H.BANKS, TITLE: President # PHONE # BUS HOURS: (805) 327-4444 '" AFTER BUS HRS: (805) 871-1623 ,EMERGENCY CONTACT: LA,R~F. A_ ADRTAMCE TITLE: A.H.T. PHONE · BUS HOURS: (905) 327-4444 PRINCIPAL BUSINESS ACTIVITY:Full Service Small Animal Hospital AFTER BUS HRS: ~805) 871-5343 ~ HMCU-9 CONTAINER CODES ~ ~ i TYPE CODES 01. Underground Tank P = Pure 02. Aboveground Tank N = Mixtures of pure 03. Fixed Pressurized Tank substances 04. Portable Pressurized Cylinders W = Wastes (Also add 05. Insulated Tank (Includes Cryogenics) appropriate waste 06. Drums or Barrels - Netallic code) 07. Drums or Barrels - Non-Metallic 08. Carboy(s) 09. Glass Container(s) 10. Plastic Container(s) 11. Box(es) UNIT CODES 12, Bag(s) 13. Metal Containers (Not Drums) LBS = Pounds 14. In Machinery or processing equipment TON = Tons (2,000 lbs) 15. Bin(s) GAL = Gallons 99. OTHER - Specify on separate sheet BBL = Barrels (42 gals) Ft3 = Cubic Feet CUR = Curies USE CODES 01. Additive 23. Herbicide 02. Adhesive 24 Insecticide 03. Aerosol 25 Instructional 04. Anesthetic 26 Lubricant 05. Bactericide 27 Medical Aid or Process 06, Blasting 28 Neutralizer 07, Catalyst 29 Painting 08. Cleanlng 30 Pesticide 09, Coolant 31. Plating 10. Cooling 32. Preservative 11, Drilling 33. Refining 12. Drying 34. Sealer 13, Emulstfler/Demulslfler 35. Spraying 14. Etching 36. Sterilizer 15. Experimental 37. Storage 16. Fabrication 38. Stripper 17. Fertilizer 39. Washing 18. Formulation 40. Waste 19. Fuel 41, Water Treatment 20, Fungicide 42. Welding Soldering 21, Grinding 43. Well Injection l~, Heating 44. 0tl Treatment 99. OTHER-Specify on ~O~ZARD CODES EXPL - Explosive ORMA - Anesthetic, Irritant CMLQ - Combustible Liquid ORME - Hazardous Waste CMSL - Combustible Solid ORMS - Other regulated Natertal B,C,and D CR~T - Corrosive Naterlal PSNA - Poison A (Gas) FLGS - Flammable Gas PSNB - Poison B (Liquid or Solid) FL~Q - Flammable Liquid RADI - Radioactive FLSI,-' Flammable So]id WATR - Water Reactive NFLG - Non-Flammable Gas ETIO"- Etiological Agent OGFX - Organic Peroxide PYRO - Pyrophorlc, Hypergoltc or spontaneously combustible OXID,- Oxidizer C~YO - Cryogenics BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Ans~ep the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# Chester FACILITY UNIT N~ME:Bakersfield Veterinary hospital, Inc. SECTION 1: MITIGATION~ PREVENTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS U.~IT ONLY See Attached Diagram and Plan. SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does'this Fac!ltty Unit contain Hazardous Materials? ...... YES NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES NO If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) If Yes, complete a hazardous materials invetltory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition tn the non-trade secret form. List only the trade secrets oll form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION $: LOCATION OF WATER SUPPLY FOR USE BY EMERGeNcY RE,PONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY, A. NAT. ' .' '" GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPEC IAI: E. LOCK BOX: YES / NO IF YES, LOCATION IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO IN CASE OF FIRE: (MAIN HOSPITAL BUILDING) SEE EVACUATION DIAGRAM l. The person discovering the fire will notify at least one other person to start evacuation of Personnel and animals from the building. AND THEN: 2. Call the Fire Department - DIAL 911 - Remain Calm and give the Fire Department: a. The name and address of the facility. b'~, The type of fire, if known. c. Any other special information such as gas explosion, etc.~ that might be of help to the Fire Department or present a special hazard. 3. The Senior Person present will: a. Ascertain that all personnel and animals are evacuated from the building. Animals are to be evacuated to the Isolation Ward, Dog Bathing Room or fenced area behind the Isolation Room (Where Nissan is kept). In an emergency, animals can be leashed to the chain link fence in the parking area indicated. b. Determine whether or not it is feasible to attack the fire with our small Fire Extinguishers. c. SAFETY OF PERSONNEL AND ANIMALS WILL TAKE PRIORITY OVER THE BUILDING AND ITS CONTENTS. 4. After evacuation is completed, ail personnel will assemble ~t the west end' of the south parking lot so the Senior Person can account for your 'safety. 5. The Senior Person will either make their self or designate one person to be available to the Fire Department for assistance and information. All other persons will stay out of the way. 6. In the event of fire in the Wash Room, Autoclave Room or Surgery, where compressed. gas is stored - Evacuate building and notify Fire Department only. Get away from the area and do not attempt to fight the fire or evacuate any of the contents of the building. IN CASE OF FIRE: (Isolation Ward, Dog Bathing Room or Storage Area) 1. Follow instructions in #1 and #2 above. 2. Evacuate animals, as necessary, to the Mai~ Hospital Building. 3. Follow rest of Pertinent instructions above.~