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Home My WebLink AboutBUSINESS PLAN (3)FINANCE DEPARTMENT ~ CITY OF BAKERSFIELD ~'iUR~ $ffRVIC~ °~ "'~ :~;'~-~ BAKERSFIELD, CALIFORNIA 93303 ,-,;S A[~ERIOAN C~~c,~m;- '' '" "' '-' ~- ~ - R~URN SERVICE REQUESTED ;:,,,~ ~,~ ~c,L~,~ :~,,'-~ ":' ~ // KON-~O0 ~B01~055 l~Oq 'ii OB/~B/Oq RETtJRN TO SENDER :STANEEY KON ~30& .~T~ 5T ~ ...................... RETURN TO SENDER B~a~.~.$~}{~[t."~os7 Ihh,,,Ih,,Ihlh,,,,lh,,I,ti llh,,,,Ih,,hfih,,,hl,h,,i, hhh,,h,,iii ~~-~ STANLEY S. KOH, D.D.S., Inc. Diplomate of American Board of Oral and Maxillofacial Surgery (661) 327'-2051 1600 F Street, Bakersfield, California 93301 STANLEY S KOH, DDS., SiteID: 015-021-002295 DEC~ 20~ BusPhone: (661) 327-2051 Manager : Location: 1600 F ST Dk~ ~ ~ Map : 102 CommHaz : High City : BAKERSFIELD Grid: 25D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 03 SIC Code:8021 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title STANLEY S KOH / DDS / Business Phone: (661) 327-2051x Business Phone: ( ) - x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact : SHELLY LITTLE Phone: (661) 327-2051x MailAddr: 1600 F ST State: CA City : BAKERSFIELD Zip : 93301 Owner STANLEY S KOH, DDS Phone: (661) 327-2051x Address : 1600 F ST State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: (Type o~pr~nt f,ame) ' ~-~%~--~"~ reviewed the attached hazardous materials manage- ,,'/7-~--~ ment plan for3~,~'lt~ ~ ,+','7~/_.~ (Nm. o~u=i~) and that it along with ~~ ~~? any co~e~ions constitute a complete and'corre~ man- agement plan for my facility. 1 12/01/2003 STANLEY S KOH, DDS., SiteID: 015-021-002295 ~ ~ inventory Item 0001 Facility Unit: Fixed Containers at Site ~ OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE REAR OF OFFICE BLDG CAS# 7782-44-7 Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 249.00 FT3I 500.00 FT3 500.00 FT3 HAZARDOUS COMPONENTS 100.00 Oxygen, Compressed N 7782447 HAZARD ASSESSMENTS TSecretl ~slBioHaz Radioactive/Amount EPA Hazards NFPA USDOT# I MCP No N No No/ Curies F IH DH / / / Low Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ /U/_~'~.d~S O~Q' ~ Days On Site 365 Location within this F ' ' Map: Grid: CAS# INSIDE REAR OF OFFICE 7727-37-9 ~ STATE TYPE ,,,/PRESSURE TEMPERATURE CONTAINER TYPE ~--Pure {Ambient PORT PRESS CYLINDER /Gas ~Above Ambient . . AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 249.00 FT3I 500.00 FT3 500.00 FT3 HAZARDous COMPONENTS 100.00 Nitr__O~t N 7727379 TSecret RS I BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP NO NO { NO NO/ Curies F P IH /'/ / Min , -4- 12/01/2003 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME <~-t'A-.,,dt.~-V 2- i<'O~, b fig ~SPECTION DATE I%/t ADD.SS [600 ~ ~ PHONENO. ~ZT- FACILITY CONTACT~~ ct~ .... BUSINESS ID NO. 15-210- ~SPECTION TIME NUMBER OF EMPLOYEES /D2 I Section 1: Business Plan and Invento~ Program ~ ~/ ~ Routine ~mbined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials 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 X,/'{)/..C',aeS/~ //~-C~t:' C{//..~,,.toLre5 Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: '~es [~]No Questions regarding this inspection? Please call us at (661) 326-3979 Business ~te)l~es~o~sible Par~ White - Env. Svcs, Yellow - Station Copy Pink - Business Copy , Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES ~/~ UNIFIED PROGRAM INSPECTION CHECKLIST ~ ('~'k, k ---] 1715 Chester Ave., y:a Floor, Bakersfield, CA ~' S'VA,-JC~-~d ~ Id'O'~ b~ mSPECTIONDATE FACILITY NAME ' ADD,SS /600 ~ 5~ / " PHONENO. %27-~. FACILITY CONTACT ~ c~ Tr~ BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES.¢' Section 1: Business Plan and Invento~ Program ~ Routine ~ombined ~ Joint Agency ~ Multi-Agency ~ '"~ Re-inspection c v cqhu .N,S Appropriate pe~it on hand Business plan contact info~ation accurate Visible address Co~ect occupancy Verification of invenlo~ 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 ,.:' / ~ ~L~ ., Fire Protection ~ ~~ .. ~,~ Site Diagram Adequate & On Hand .> ,' .' C=Compliance V=Violation .~ Any hazardous waste on site?:' ~es ~ No ,~'~_ / Questions reg~ding ~is inspection? Please call us at (661) 326-3979 ..-.: Bus~ness ~espons~ble Pa~y White- ELy. Svcs." Yellow- Station Copy Pink-..~?ausi.ess~ Copy~ '/ Insp~tor: ' ~¢ ~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3~ Floor, Bakersfield, CA 93301 FACiLiTY NAME ~T/X*./L~y 5;. ti. oM , ODS 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 EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) 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 kept 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 Inspector: {,,~1/~'""~ Office of Environmental ~ervices (661) 326-3979 Business Stite~Responsible Party White - Env. Svcs. Pink - Business Copy ~E OF ENVIRONMENTAL"~JERVICES ~l~lmrm~ 1715 Chester Ave., CA 93301 (661)326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION · (one form per ma tedal per building or ama) ~ NEW ~ ADD ~ DELETE ~ REVISE 200 Page ~ of · ' ~.~.~:~:?~.~.:*~:~:~. ~;~: .~ : . '. * ~. I. FACILI~ INFORMATION .':,¥~*~:~?~/'.'~' ~+:~,:;:~: BusINess ~E (sa~e ~' ~lL~-~"~g~Z'b'~[~"[~[~'~'~ 3 c.~o~,o. / ~.~ ~ ~ ~ ~cC ~o~: C,~M,C~o~,o, ~ L~ ~ CONFIDENTIAL (EPC~) ~ Y~ ~ No 202 FACILI~ .~ I I CHEMI~L ~ME ~ If Subj~ to EPC~, mf~ to instm~i~s COM~N~ ..... [ EHS~__ DY~ ~No 2~ ........................................................................ I '"' CAS ~ m.... :~: ::;~/~:~ ~ ::~ ::,,.; FIRE CODE ~RD C~SSES (~plete if ~u~t~ by t~l ~re chie~ 210 ~PE ~ PURE ~ m MIXTURE ~ w WAST~ 2:; ~ RADIOACTIV~ ~ Y~ ~ No 212 ~ CURIES 213 ~g ' ~RGEST CO.AINER ~ 215 PHYSI~L STATE ~ s SOLID ~1 LIQUID ~S 214 ~ FEO H~RD ~TE~RIES ~ 1 FIRE ~ 2 REACTIVE ~. PRESSURE RELEASE ~ 4 ACUTE HEALTH ~ 5 CHRONIC H~TH 216 (Ch~ all ~at apply) ANNU~WASTE 217 ~ M~IMUM ~ 218 { AVENGE 219 STA~WAS~DE A~U~ _j. DAILYA~U~ ~ DAILY A~UNT UNITS* ~ ga GAL ~ CU ~ ~ lb LBS ~ tn TONS ~1 DAYS ON · If EHS, am~nt must be in lbs, STOOGE CONTAINER ~ a A~VEGROUND TANK ~ e P~STI~NONMETALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL CAR 223 (Check afl ~at apply) ~b UNDERGROUND TANK ~f CAN ~j BAG ~n P~STIC BO~LE ~r O~ER ~ c TANK INSIDE BUILDING ~ g ~RBOY ~ k BOX ~ o TOTE BIN ~ d STEEL DRUM ~ h SILO ~CYLINDER ~ p T~K WAGON STO~GEPRESSURE ~ a AMBIENT a ABOVE AMBIENT ~ ba BELOWA~IE~ ~4 STOOGE TEMPE~RE ~ AMBIE~ ~ aa ABOVE AMBIENT ~ ba BELOWAMBIENT ~ c CRYOGENIC 225 226 227 ~ Y~ ~ No 228 230 231 ~ Y~ ~ No 232 233 2M 235 ~ Y~ ~ No 236 237 238 239 ~ Y~ ~ No 240 241 242 243 ~ Y~ ~ No 2~ 245 PRINT NAME & TI~E OF AU~ORIZED COMPA~ REPRESENTATIVE SIGNATURE DA~ 246 I UPCF (7199) S:\CUPAFORMS~,OES2731.TV4.wpd ,~o~r~ ~n...~ ~. CITY OF BAKERSFIF~ I~ICE OF ENVIRONMENTAL~RVICES MAM~MM~ 1715 Chester Ave., CA 93301 (661) 326-3979 "~~~' H~RDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one fo~ per matedal per building or ama) 200 Page ~ of ~ NEW ~ ADD ~ DELVE ~ REVISE BUSINESS ~ME (Same ~ FACILI~ NAME or DBA - Doing Busings ~) 3 205 ~ T~DE SECR~ ~ Y~ .............. 207 [ FIRE CODE H~D C~SSES (~plete if ~u~t~ by I~1 fire ~ie0 210 WPE ~ PURE ~ m MITRE ~ w WASTE 2:; RADIOACTIVE ~ Y~ ~ No 212 [ CURIES 213 PHYS/~L STA~' Ds SOLID D, LIQUID ~ GAS 214 ~RGEST CONTAINER ~ 215 FED H~RD ~TE~RIES ~ 1 FIRE ~ 2 R~CTIVE ~ PRESSURE RELEASE ~ 4 ACUTE H~L~ ~ 5 CHRONIC H~LTH 216 (Ch~ all that apply) ' 2~ ~ Av~E ~ STA~ WAS~ ~D~ ANNUAL WAST~ ~ :~,MU~ ~ DAILYA~U~ ~ DAILYA~UNT A~U~ DAYS ON SITE UNITS* ~ ga ~L ~ ~ CU ~ ~ lb LBS ~ tn TONS 221 * If EHS. am~nt must be in lbs. STOOGE CONTAINER ~ e ABOVEGROUND T~K ~ e P~STIC~ONMETALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL C~ (Check afl ~at app,) ~ b UNDERGROUND TANK ~ f CAN ~ j BAG ~ n P~STIC BO~LE ~ r OTHER ~ c TANK INSIDE BUILDING ~ g CAR~Y ~ k BOX ~ o TO~ BIN ~ d S~EL DRUM ~ h SILO ~CYLINDER ~ p T~K WA~N STOOGE PRESSURE ~ a AMBIE~ ~a ABOVE AMBIENT ~ ba 8FLOW AMBIE~ ~4 STOOGE TElEWaRE ~AMBIE~ ~ aa ABOVE AMBIENT ~ ba BELOWAMBIENT ~ c CRYOGENIC ~5 1 226 227 ~ Y~ ~ No 228 230 231 ~ Y~ ~ No ~2 ~3 234 235 ~ Y~ ~ No 236 238 239 ~ ~y~ ~No 240 241 242, 243 ~Y~ ~No 2~ 2 5 '"' ~ ' ' "' ' ...... DA~ 2~ PRI. NAME & TI~E OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE UPCF (7199) S:\CUPAFORMS\OES2731.TV4.wpd CITY OF BAKERSFIE~ (~ICE OF ENVIRONMENTAL~R'ERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 '"~'""~~'~"" HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per materfal per building or area) [] NEW [] ADD [] DELETE [] REVISE 200 Page __ of __ . ~ "~ .~ '~'~ \.. !,%;L'; ,:¥' '~5¥!'~ ," ' ' · .... '~ -' · ...... ';' ~ ' ..... ' ~ ;*-~"~' "?' ' I. FACILI~ INFORMATION ~;- _ ; ~:;:¢:~:k;;~%~ BUSINESS ~ME (Same as FACILI~ NAME or DBA - Ooing:'Busin~s ~) ................................... 3 I ~ ~ ~ ~ CON~OEaT~aL(EPC~) FACILI~ ID ~ ~ ~ ~ ] , ~ ~P ~ (op~naO 203 ~RID ~ (op~naO 2~ 205 T~DE SECR~ ~ Y~ ~ NO 206 CHEMI~L ~ FIRE CODE H~RD C~SSES (~mpete if r~u~t~ Dy l~l fire ~ie0 210 ~PE ~ p PURE ~ m MIX. RE ~w WAST5 2~: ~ RaO~OACT~Va ~ Y~ ~ .o 2~2 ! CURIES ' 213 , . PHYSI~LSTA~ ~ s SOLID ~IQUID ~ g ~S 214 ~ ~RGESTCO~AINER ~ 215 FED ~RD CATE~RIES ~ 1 FIRE ~ 2 R~CTIVE ~ 3 PRESSURE RELEASE ~ ACUTE H~LTH ~ 5 CHRONIC H~LTH 216 (Ch~ all that apply) ANNUAL WASTE 217 ; M~IMUM .~ 218 [ AVENGE ~ 219 ~ STA~WAS~DE UNITS* ~ ~L ~ d CU ~ ~ lb LBS ~ tn TONS ~1 [ DAYS ONSITE 2~ * If EHS, am~nt must be in lbs. I STOOGE CONTAINER ~ a ABOVEGROUND T~K ~ e P~S~C/NONMETALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL ~ 223 (Check afl ~at apply) ~ b UNDERGROUND TANK ~ f CAN ~ j BAG ~n P~STIC BO~LE ~ r O~ER ~ c T~K INSIDE BUILDING ~ g ~R~Y ~ k BOX ~ o TOTE BIN ~ d STEEL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WAGON STOOGE PRESSU~ ~ AMBIENT ~ aa ABOVE AMBIENT ~ ba 8ELOWAMBIE~ 224 STOOGE TEMPE~RE ~ a AMBIENT ~ aa ABOVE AMBIENT ~ Da BELOWAMBIE~ ~ c CRYOGENIC 225 1 ~6 227 I ~y~ ~No 228 2~ 2 230 231 ~ ~y~ ~No 232 233 3 2~ 2 ~Y~No 236 237 4 238 239 } ~y~ ~No 240 241 .--~ 5 242 . 243 ~ ~ y~ ~ No 244 245 PRINT NAME & TITLE OF AU~ORIZED COMPANY REPRESENTATIVE SIGNATURE DA~ 246 UPCF (7~99) S:\CUPAFORMS\OES2731.'r¥4.wpd