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Home My WebLink AboutBUSINESS PLAN / nag~r ~ ~ ENTER .~ Location. 2920 F ST B 2 Sz ~ty : BAKERSFiELd- .<~ 'teI~: O1 / CommCod m ~ BuSPho- o-u21_002~o~ e. ' He: / EPA Num~' BAKERSFim~ Map . n~ (661) ~ SI =acunits: 1 / Emergency Co ~ ~ c Code: AOV: / J~UDy HURT ntact / Title nUSiness Phone: (66~) OWNER ~j2~u~ Phone . , .... Emergency Contact =~ ~nOne · ~o~z] 322-2089x WILLIAM BARKER / TitZe · 872-7195x BUSiness Phone: ( : 834_4111~ Contact ~e~ =~one ~ ( ) MailAddr: ) City : 2920 F ST B_2 React : BAKERSFIELD Owner Phone: (661) 322_2089X Address JUDy HURT State: CA City : 2920 F ST B_2 ~P : 93301 : BAKERSFIELD Period : PhOne: (661) 322-2 Preparer: State CA 089x Certif,d: to : ParcelNo: ~ Zip : 93301 T°talASTs: T°talUSTs: Emergency Directives: RSs: No Ga/ Ga/ re~,,is ~,::~:o th~. at~ached hazardo- ~ny ~rre~ions COnstitut~ a comple~ and COrr~ ma~. agement plan for my facility, 07/15/2003 BAKERSFIELD RADIOGRAPHI ENTER SiteID: 015-021-002383 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 07/18/2002 DOUBLE CONTAINERS, CK CONTAINERS DA~~YSOLUTION SERVICE COMES EVERY FRIDAY. THEY ALSO CLEAN ALL PROL~ESSORS ONCE EVERY 4 TO 6 WEEKS NOTIFY MANAGER JUDY H~T -- Release Containment 07/18/2002 CLEAN UP CONTAINMENT AND CALL 664-77~0 ~ER -- Clean Up 07/18/2002 PUT DOWN KITTY LITTER SCOOP IN TO SEALED CONTAINER CALL XRAY SOLUTION FOR PICK UP ONLY A MAX OF 11 GALS OF XRAY FIXER IS KEPT ON HAND ALWAYS IN PLAIN SITE IN DARK ROOM: PLASTIC SCOOP KITTY LITTER SAFETY GLASSES GLOVES NOTIFY JUDY ~D XRAY SOLUTION SERVICE (661) 664-7760 Other Resource Activation 6 07/15/2003 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, remm this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner / Operator Form and Chemical Description Form(s) to the front of this plan instead of completing SECTION I. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA LOCATION: ~~ ~ ~t_._ ,b'-' 2--.. MAILING ADDRESS: ~ PRIMARY ACTIVITY: MAILING ADDRESS: ~ EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 tR. I~HONE . ~ r OI~CE OF ENVIRONMENTAL .... 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN Section I1.1 - DISCOVERY AND NOTIFICATIONS I. FACILITY IDENTIFICATION BUSINF..~ NAME (Same as FACILITY NAME or DBA~- Do~ng Bu~ness As) 3 ADDRESS (For local us~only) A ~ f ~ - ~ 4?6. DISCOVERY B. EMERGENCY ~D AGENCY NOTIFICATION PROCEDURES: 'D. CLOSEST LOCAL MEDICAL FACILIW:.~ ~ uPCF (7/99) S:~PROCEDURE MANUAL~Iew HMMP fmm.wpd Section 11,2 - RELEASE RESPONSE PLAN PRELIMINARY ASSESSMENT REsPoN$'E ACTIONS. ~; . . , '~:~ ~ B. RELEASE CONTAINMENT AND MITIGATION: ~ ~ '~.. ~ ~---~'~ FOLLOW-UP ACTIONS UPCF (7~99) $.'~RQCEDURE MANUALY~v HMMP HAZARDOUS MATERIALS MANAGEMENT PLAN Section II1,1 - FACILITY AND LOCALITY INFORMATION UTILITY SHUT-OFFS LOCATION OF SHUT-OFFS AT YOUR FACILITY: NATURAL GAS/PROPANE: SPECIAL: ,. ~' ~,~ A. ~RIMATE FIR~TEC 'TRAINING A. NUMBEROF EMPLOYEES: ~ B. MATERIALS DATA SHEETS ON FILE: C BRIEF SUMMARY OF TRAINING PRO~RAM: CERTIFICATION Based on my Inquiry of those individuals responslbta for obtaining the infom~atJo~, I ~ unde~ penalty of law that I have personnaly examined and am familiar with the information submitted a~d betieve the inform~Uo~ ls true, accurate, a~l complete. SIGNATURE OF OWNER I OPERATOR OR OESlGNATEO REPRESENTATIVE DATE - 477. UPCF (7/99) S:IPROCEDURE MANUAUd,~ew HMMP fo~n.wpd O~ICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER / OPERATOR IDENTIFICATION FACILITY INFORMATION Page I. FACILITY IDENTIFICATION ~-,~ ¢ Year Beginning BUSI~J~S~S N,~ME (Same as FACILITY NAMF.~ DBA-Doing Business As) r 3 BUSINESS PHONE 102 103 SIC CODE COUN~ ~~ CONTACT NAME ~ ~z CONTACT PHONE CITY ~2o STATE ~2~ j ZIP PAGER ¢ 12B PAGER ~ 133 '; ' > ' CERTIFICATIO'; Ce~iflcaaon: Based on my inqui~ of ~ose individuals responsible for obtaining the info~ation, I ~ under penal~ of law ~at I have personally examined and am ~miliar with the info~ation submiRed in this invento~ and believe the information is true, a~urate, and ~mplete. SIG~TURE OF OWN~OPE~TOR DATE,/ l~ j NAME OF DOCUMENT PREPARER ~F OWNE~OPE fO~' ~E~F~WNE~OPEgTOR~~ff~~ (print) 136 ~~~ff ¢~ 137 UPCF (7~99) S:\CU PAFORMS\OES2730.TV4.wpd CITY OF BAKERSFIE] OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per material per building or area) [] NEW [] ADD [] DELETE [] REVISE 200 Page __ of __ '. ,- L FACILITY INFORMATION I CONFIDENTIAL (EPCRA) [] Yes o 202 FACILITY ~-D # I I ~' I i,~;~l i i I I MAP # (optional) 203 GRID # (optional) 204 ' '' ' ..':',;~ '. II. CHEMICAL INFORMATION . 205 TRADE SECRET [] Yes 206 If Subject to EPCRA, refer to instructions CHEMICAL NAME ~,..~ 207 COMMON NAME .~ ~-iz,~~,y~'E'~'n'''f ''''q EHS* [] Yes o 208!" CAS # 209 *If EHS ia'Yes, ' all amounts betow r~ust be is lbs. ' FIRE CODE HAZARD CLASSES (Complete if requested by local fire cflief) 210 TYPE ~-1 p PURE [] m MIXTURE '~w WASTE 211 i RADIOACTIVE []Yes '~o 212 CUR'ES 213 , ...~~ PHYSICAL STATE 215 FED HAZARD CATEGORIES [] I FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH ~,~ 216 (Check all that apply) ANNU^L WAST~V'/~A 2~7 MAXI~M 220. ' DALLY AMOUNT A~,~ ~ DAYS ON S, TE ' 222 U.,TS'~ga GAL .BS [] tn TONS 22, :,.,~ * If EHS amount must be in Ib~. STORAGE CONTAINER [] a ABOVEGROUND TANK [] e PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTFLE [] q RAIL CAR 223 (Check all that apply) [] b UNDERGROUND TANK [] f CAN [] j BAG ~ PLASTIC Bo'ri'LE ' [] r OTHER ,,~c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BI*N STEELD.UM S'LO [], C ',NOER TAN. WAGON .~ [] aa ABOVE AMBIENT [] ba BELOVVAMBIENT 224 /'~ STORAGE TEMPERATURE ~a AMBIENT ~ ~ [] aa ABOVE AMBIENT [] ba BELOW AMBIENT [] c CRYOGENIC 225 '~ o 228 220 2 250 231 [] Yes [] No 232 233 234 235 [] Yes [] NO 236 237 238 239 [] Yes [] NO 240 241 242 243 [] Yes [] NO 244 I 245 · IGNATURE :~, ~'::'~ ~;~¥,~.. ~,. ~,' 'X ~,:~", .... ~ PRINTNAME&TITLEOFAUTHORIZEDCOMPANYRyRESENTATIVE~._{,~O~/.~.~._~/~.~~ ~~ ~. DATE 246 ,~ ~ UPCF (7/99) S:\CUPAFORMS\OES2731 ,TV4.wpd 2920 'F" Street, Suite B-2 ~ ~' ~ NO~ ~, ' 30th Stree[ (Lc cared in the - ~Z' ~ ~ ".t' Bakersf~elld Radiographic Ce JUDY HURT Lab Owner, Manager Radiographic Technician 2920 F Street Suite B-2 Bakersfield, CA 93301 PHONE(661)322-2089 ,~AX(661)322 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST t~/~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME '~OCL''n--cg:~c'~° ~M~~C. INSPECTION DATE~,(°/4/~'Z.._ ADDRESS 9.q7_.0 ~' 5~ {~-'2_- PHONE NO. 2'2-'Z - FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~ Routine 0~ Combined I~] Joint Agency ~ Multi-Agency ~l Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand ~ (3C-'e'Cnntq''- <d ~q"~ Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials b,.At~T~ Verification of quantities ..K"'- Verification of location t ,,O~,0~ ~[¥'ta~ ~ 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?: ~]-Yes [~] No Questions regarding this inspection? Please call us at (66 I) 326-3979 Business Site ReSponSible 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 ~(_n~ ~~t4~ CC~a-r-Ccc INSPECTION DATE Section 4: Hazardous Waste Generator Program EPA ID # FI Routine ~ Combined Fl Joint Agency Fl Multi-Agency [] Complaint I"1 Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made ~ ~ .UL~._n~<~ ~ ~ EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) Authorized for waste treatment and/or storagekN~t///~ 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 x~ Containers are compatible with the hazardous waste Containers are kepi closed when not in use // Weekly inspection of storage area ConductsIgnitable/reactiVesec°ndarYdailyC°ntainmentinspectionWaSte providedl°catedof tanksat least 50 feet from property line (/ Used oil not contaminated with other hazardous waste of lead acid batteries including labels '~ Proper management of used oil filters,~, Proper management Transports hazardous waste with completed manifest J Sends manifest copies to DTSC manifests for 3 years / Retains 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 Office of Environmental' Services (661) 326-3979 BuSiness Sit~ ResponSible Party White - Env. Sves. Pink - Business Copy