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Home My WebLink AboutHAZ-BUISNESS PLAN 6/12/1998KERN RADIOLOGY MEDICAL GROUP, 2301 Bahamas Drive Bakersfield, CA 93309 - (805) 322-1981 Department of Toxic Substances Control Onsite Hazardous Waste Treatment Unit P.O. Box 806 Sacramento, CA 95812-0806 Dear Sir or Madam: Please see the enclosed Onsite Hazardous Waste Treatment Notification Forms for Kern Radiology Medical Group, Inc. If you have any questions please call me at (805) 322-1981 ext. 236. Thank you, D'Ln Brown Compliance Manager Mailing Address: P.O. Box 2388- Bakersfield, CA 93303 - Fax No: (805) 324-1298 Page I of' ONSITE HAZARDOUS WASTE TREAIWIENT NOTIFICATION FOR1VI- FACILITY SPECIFIC NOTIFICATION ~] Initial FOr Usc by Hazardous Waste Genm~tor~ p~rformin~ Tream~em [] Ame~led Under Conditiotml Exemption and Conditional Authorization, and by Permit By Rule F~-ilitics Please refer w the attached Instructions before compltting this form. You may notify for more than one permitting tier by using this notification form, D~$C 1772. You mart attach a $~arate #nit $pecific notification form for each unit at this location, l'here are different unit xpecific notification for~ for five o/the categorle~ and an additional notlflc#tion form for tmntportable tramm~ tmtt~ (I77J'$). you only have to submit fom~ for the tier($)/category(i~) that cover your unit(~). Discard or recycle the other unttted fortaz. Number each page of your completed notification padmge alut indicate the total mtmber of pag~ at the top of eatYt page at the 'Page __ of__'. Put your EPA ID Number on each page. Pleaxe provide all of the information requested;.all fieldr rnu~t be compltted ezcept those that state 'if different' or 'if available'. Plz~e type the information provided on thiz form and arty artachrnentz. The notifcation fe~s are assessed on the basis of the highest tier the notifier will openve under and will be collected by the State Boo_rd of Eq,,-tfr~on. DO NOT SEND YOUR FLg~E PAI~EI~I' WI~ THIS NOI~ICAITON FORM. I. NOTIFICATION CA'I'F,C~)RIF, S Indicate the number of traits you operate in each tiff. This will alto be the number of trait specific notification forms you must attach. Conditionally Exempt ~ ~ Treamttnt opo~tort amy not operate traits trader any other tier. Number of units.and attache!l,, unit specific uotificafiom for each tier reported. A. Coiulifioaally E.xe~pt-$m~" Quantity ~r~ama~.-(~'~) . D ......... Pemfit by Rule {P~R3/... · B. x C_oaaitioa~y ~--~t-S. pecifiea wm~ (CESW) ..l~ ...... C:F._-Co,mm~.!-,,,~','y C. . Conditionally Aumofiz~ (CA) ......... · ............. F. II. GENERATOR IDENTIFICATION EPA ID NUMBER CAL 0Q._ .Q_ .~_ 4_ ..fi..3_ 2 6 BOE NUMBER (%f available) H_HQ_ ....... FACILITY' NAME (oaA-voia~ ~ As) PHYSICAL LC~3AT'ION KERNRADIOLOGY MEDICAL 3700 MALLVIEW ROAD GROUP. INC.-KAISER EAST NlI,l,S BAKERSFIELD- KERN CA ~93306 COUNTY CONTACT PERSON D'LN ~ llama) BROWN (~ Ntu~) PHONE NUMBER( 805 MAII/NG ADDRESS, IF DWFER.ENT: COMPANY NAME KERN RADIOLOGY MEDICAL GROUP, %NC. 2301 BAHAMAS DRIVg crrY BAKERSFIEI,D STATE CA ZIP 93309 COUNTRY CONTACT PERSON DTSC 1772 ( 1/96) (ot~y complct~ ~ not USA) D'LN (Fun~ Name) BROWN fi.ut Name) PHONE NUMBER(.gi3.5._) q?? ' 1981 Page ' EPA ID NUMBER CAL000026 RADIOACTIVE MATERIALS OR WA~'rE NO [] Does the facility u~, stor~ or Ur. at radioactive materials or radioactive waste? Page 2 of IV. TYPE OF COMP,~NY: STANDARD INDU~ CLA~SI~CATION (SIC) CODE: Use either one or t~o SIC codes (a four digit number) that best describe your company°$ products, services, or industrial activity. F_xantp~: 7384 Photofini~hine lab 7'~11~ Indurtrial launderer~ First: 8011 MEDICAL OFFICE Second: ?38/+ PHOTOFINISHING LAB CLINIC PRIOR PERbllT STATUS: Ch~ak yes or ~o to zar. h q~_e_m_'__~. Did you file a PBR Notice of Inte~ to Operate (DTSC Form 8462) in 1992 for this location? Do you now have or hav~ you ever held a state or federal h-~.,dons waste facility full permit or interim status for any of these tmanmnt nnits? Do you now have or hav~ you ever held a state or federal full permit or interim status for any other h,,?~,nious wa.~.~ties at this loc~i~? ' -' Have y°u-~-r'h~l-d ~ varia~-iSsued by the ~t Of Toxic are now nofifyi~ for at ~hi, location? ............... VI. PRIOR ENFOR~ m.~ORY: YES NO .NOt required from conditionally e~empt generators or commerdal laund~. Within the last three years, has this facility been the subject of any coavi~io~, judgments, settlements, 'or final orders r~'ulting from an action by any local, state, or fedi:ral environmental, h=~,rdous was~, or public i~.~lth e~forcem~ agency? (For the purposes of this form, a notice of violation does not constitute an order and need not be r~lmned unless it was not corm:ted and became a f~,,,,! order.) [2 If you answered Yes. check this box and attach · listing of convictions, judgments, settlements, or orders and a copy · of the cover sheet from each documont. (See thc hstmctions for more information) ATrAC~: Attac~ are not requ/red from commerc/a//aundr/es. 1. A plot plan/m~, detailing the location(s) of the covered trait(s) in relation to the facility boundaries. 2. A unit specific not/fication form for each unit to be covered at this location. DTSC 1772 (1/96) Page 2 £PA ID NUMBER CALOi Page 3 of CERTI~CATZON$: ~L~ /~rm rntat be ~igned by an ttuth~rited corporate officer or any other per~on in the company who /u~ operational control and perfornu decition-malcing fun~ions that govern, operation of the facility (per Title 22, California Code of Regulations (CCR) Seaion 66270.11). Ail three copies mu.vt iu~e original ~ignamre$. Waste Minimization I certify that I have a program in place to reduce the volun~, ~, and toxicit~ of wn.ste gez~=ated to ~ degree I have determined to be econctmically practicable and that [ ~lave sel~"l~d the practicable method of ur. atm~t, storage, or disposal curz~tly available to me which minimi?~.e the pre,at and' furore threat to b,,mnn health and the e~virm:ull~at. Tiered Permtttiqg (;ertlflcntion I certify ,hat the unit or units d~cribed in these docum~ts meet the eligibility and operating requirements of state stam,_e~ and reg,,~,t~ons for the indica~d permitting tier, including generator and secondary containment requirements. I understand that ff any of the units operate under Pm'mit by Rule or Conditional Authorization. l will also provide thc required financial assurance for clonn~ of the treann~nt unit by, October 1, 1996. I certify under penalty of law that this document and all attachments were prq~ under my dim:tion or mpervision in acronlam:e with a system designed to assure that qualified pe~mnel properly gzlhn- and eval,,s,e the inforrnn,ion submiued. B,tsed on my inquiry of the person or persons who znanage thesystem, or those directly r~xauible for ~ttering the informa!i. 'on, the information is, to the best of my knowledge and belief, true, accuray, ami complete. I am aware that the~ a~ sul~nant~ penalties for ~,hm~g'fal~ information, including the possibility of fines and ~ for knowing violations. DAVID P. SCHAL, E, M.D. Namc~Print or Type) Signam~ PRESIDENT Title Dat~ Signed ............... ~ -..-..... ....... :..- ~ -~ .--- REQUF..STING A SHORTENII) ~ PlatlOD:.-- Gm,retort o.,~zr/ng ~,der C,4 and/~- C~ ~'e ~g~b' az,z/miii~'~'-"- to operate 60 days after submitting a complete notification. DISC may zhonen the time period between notification and authorization when the owner or operator establi~he~ good catae. If you need to be authorized sooner than the ~tandard ....... 60-day period, pleaxe check the box below and etate the raua~' Your authoritation will be autotnatically effective on the - date your completed notification form is received by DISC. (Use nel,41~ional sheets, if nece. axary.) OPERATI3IG REQUIR.IilM~: Please note that generator~ treating imzani~ wa. gte onlite are retlui~ed to comply with a number of operating requirenu~ which differ depending on the tier(s). The. se operating requirements are set forth in the statut~ and regulations, some of which are referenced in the ~ier-$pecific Fact Sheet~ amilable from D2~C'$ regional and headquaner~ SUBMISSION PROCEDURES: All three forms must ha~e original tignaturts, nm photo~opitt. certified mail, r~turn receipt requested, to: You must submit two copies of this complete! notification by Department of Toxic Substances Control Program Data Management Section, HQ-10 Ann: TP Notifications. Form 17'/2 400 P Street, 4th Floor, Room 4453 (walk in only) P.O. Box 806 Sacrameato, CA 95812-0806 You must also submit 9ne cgpv of the notification and attachme~u to the local regulatory agency m your jurisdiction a~ listed in oendLx 2 of the/nstmaion materials. You must also retain a copy as pan of your operating _record. PI;EASE, DO NOT SEND YOUR FEE PAYMENT WITH THIS FORM. DTSC 1772 (1/96) Page 3 EPA ID NUMBER ~ Page._. ~f CONDITIONALLY EXEMPT-SMALL QUANTITY TREATMENT UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safeay Code Section 25201.~(a)) The Tier-Specific Fact sheets contain n sunmmry of the o~ requirem~n~ for this eatego~. review those requirements ~ before completin~ or submittin~ ,h~_q notification NUMBER OF TREATMENT DEVICES: Tank(s) Contaiacz(s)/ComaiaerT~t~s) IIPlease Note: Generators operating units under Conditionally Exempt Small Q-nntity Treatment may not operate any other ,,nits under other permini_ 'ag tiers or hold any other state or federal hazardous waste permit or authorization for thin facility. Each unit must be clearly identified and labeled on the plot plan attached to Form 1772. A~ign your own unique number to each unit. ~ number can be sequential (1, 2, 3) or you may ate any O~t~n you choose. 2his category i~ only available to generaton that treat !et~ than 55 gallont or 500pounds of hazardo~ waste in any calendar tnonth in ALL ~ at this facility and that are not other~e required to obtain a hazardous waste facilit~ permit. ~ volume limit applier to the ~ hazardou~ waste treated onsite in arty calendar month, and.i~ ~VOT a limit for each warttrtream or unit separately. 2'he wa~.. textrearn$ treated must be limited to those listed in 2'ttle 22, CCR, Section 67450.12, which are alto ILvted ~elow. Enter the estimated monthly total vol~-of hazardous wa3te treated by this unit. 27tjx should be the ~ or highest amount treated in any month. Indicate in the narrative (Seaion ll) ~f your operation~ have seatonal variations.' Estimated Monthly Total Volume Treated: NO [] Is the waste treated in this u~tit radioactive? pounds and/or' gallom ~'] [] Is the wazte Ixealed in th~ unit a bio-hazardous/infectioua/medical ~? [~ ~--] Is r~motely genm-a~ hazardouz wa~ (HSC 25110.10) treated in this unit?. 2'he following are the eligible warte~treanu and treatmem procexse$. Pleme check all applicable boxes: Aqueous wastes containing hexavalent chromium may be treated by the following process: a. Reduction of hcxavalent chromium to Ixivalcnt chromium with sodium bisulfite, sodium m~tab~fi~, sodium thiosulfatc, ferrous sulfate, ferrous sulfide or sulfur dioxide provided both pH and addition of the reducing agent are automatically controlled. (_ DTSC I772A (1/96) Page 4 EPA IX) NUMBER Page of CONDITIONAI,LY EX . -SMALL QUANTITY TREA UNIT SP£CIFIC NOTIFICATION (pursu~ ~o Health ~d Safety Code S~ction 2~201.~(a)) The Tier-Specific Fact Sheets contain a summary of the operating ~ for this category. Ple~ review those requio,ments carefully befoFe compI,.elng or sub~ thlq notification UNIT NANIE METALLIC REPLACEMENT TRICKLE DOWN ~ ID N~]~ NUMBER OF TREA~ DEVICF~: 0 Tnk(s) ,.1 Contain~s)/Ccmt~i,,~r Tr~z~nt Ar~a(s) I I II Please Note: Generators operating ,,nits under Conditionally Exempt Small Quantity Treatment may not operate any other units under other permit_ 'nfl tiers or hold any other state or federal hazardous waste permit or authorization for thi~ facility., , Ea~ unit must be clearly identified and labeled on the plot plan attached to Form I772. A~ign your own unique number to each unit. 27~e number can be sequential (I, 2, $) or you may ~e any O~tem you choose. ' This category i~ only available to generator~ that treat left than 55 gallm~ or 500 poundt of hazardotts wGs~ in any calendar month in ALL ~ at thi~ facility and that are not other~¢ required to obtain a hatardom warte facilitle~ permit. ~ volume limit applie~ w the :TOTAl, hazardou.v wa. rte treated on, re in arty calendar month, and.i~ NOT a limit for each wast~,eam o.r unit separately. 2the wa~te~tream, v treated rnu~t be limited to those listed in ~ttle 22. CCR, Section 67450.12, which ar~ ~ li.rted below. Enter the e~timated monthly total volu~-of hazardou, r wmle treated by thi~ unit. ~ ~hould be the ~ or high~t amo~_~.__ treated in arty month. Indicate in the narr~ve (Section II) Oryour opemtion.v have seasonal mliatio~.' ......... ........... Estimated Monthly Total Volume Treated: pounds and/or' 60 gallons YES NO Is the waste treated ia this u~it radioactive? the waste zxe. a~d ia tiffs unit a bio-hazatdou~/iaf~ctioua/medical wa~? ~ ~] is r~motely genm-ated hazardous wasto (HSC 25110.10) u~ated in this unit?. The following are the eligible wazte~trearns and treatmtnt proce~$~. Please check all applicable boxy: I. Aqueous wastes containing hexavalent chromium may be treated by the follov~ing process: Reduction of hcxavalem cbxo~um to u-iv:dcm chrmnium wida sodium bisulfir~, sodium m~abi~fitc, sodium thiosulfate, ferrous ~alfate, ferrous sulfide or sulfm' dioxide pwvided both pH and addition of the reducing agent are automatically controlled. DTSC 1772A (I/96) Page 4 EPA ID NUMBER CAL000 ;26 Page__ of CoNDrTIONALLY ~. SI~E~ WASTESTREAMS UNTT SPECIFIC NOTifICATION - (pursuan~ ~o Health md S~ery Code Section 25201.$(c)) [==] 10. ~] 11. Gravity separation of the following, including the use of llocculan~ and demuisUiers fi: a. Thc set/ling of solids from thc waste where the resulting aqueous/liquid stream is not hazardous. b. The separation of'oil/water mixtures and separation sludges, if the average oU recovered pet month is leas than 25 hazels (42 gallons per baXT~). (~[0'1~: ,,~ 4~ (C~ ~2J. 1~.~) ~w$ ceftin u.~ed oiD~z~er separation under new the*C~Z, category. See Form 1772L and C~L Fact Sheet.) Neutralizing acidic or alkaline (basic) material ItY ·sUte certified laboratory, · laboratory operated by an educational institution, or a laboratory which Wears less than one gallon of omite generated hazardous waste in any single batch. (To be eU~lble for conditional exemption, thlt wa~e cannot contain more than 10 petxn~t acid or base by weight.) Hazardous waste Wcaunent is caFried out in quality contFoi or quaUty asanunmce laboratory at · facility timt is not an ofT3ite bazardmas waste facil/~. A wmaesU~am and U'em2nent technology combintkm certified by the Deparunent pursuant to Sec~on 25200.1.5 of the Health ·nd Safer7 Code as appropriate for authorization under CESW. Plense enter ce'tff'Kmtlon number:. [-~ 12. The' treatment of formaldehyde or glutaraldehyde by · health care facility using a technology .... . .... com..binati~n .~.,~ed by.the. '~ent. imtsmntto ~egflm~,q200.1.S-of gl~e.l~aalth-and ........ · Safety Code. Please enter certification number:. ........... -* - ·..NARRATIV~ DESCRIIvrlONS: .~ a. brief detcrip~on of the ~M:~c wmr~ tJ~rted and thg ~ proc~ u~ed.--:~ i:- 1. SPECIFIC WAST~ TYPES TR.F.A'rl]z): SPENT RADIOGRAPHIC FIXER SOLOUTION CONTAING SILVER 2. TP. EAT~ENTPROC~) USED: SILVER RECLAIMER CARTRIDGE USING IONIC EXCHANGE mo ~qlDUAL MANAG]~]~N'T: Check Ye~ or 3Io to each qutmion tt~ it trppli~ to all rgtidual~ from ~ tremment unit. 0 I. Do you discharge non-h---~,dous aqueous waste to a publicly owned ueatment works (PO'l'W)/sewet? 2. Do you discharge non-hazardous aqueous waste tmdcr an NPDES permit? 3. Do you have your residual hazardous waste hauled off_nite by a registered h:~?a~ous waste hauler?. If you do. whm'e is the waste seat? C~eck a/l thru ap.a/y. !'~ a. Offsite tecycl~g 1-~ b. Thermal treatment D c. Disposal to land [] ,4. Further treatment 4. Do you dispose of non-hazardous solid waste residu~ at an offsite location? 5. Other mctho<l of disposal. Specify: DTSC 1772B (1/96) Page !1 EPA ID NUMBER CONDITION~T.LY EXEbl]~- SPECIFIED WA~VF.~'I~ UNIT SPECX~C NOTIFICATION (pursuant to Health and Safety Code Section-25201~(c)) IV. BASIS FOR NOT NEEDING A FEDERAL PERMIT: In order w demonstrate eligibility for one of the on.die treatmem rier~, facilities are required to provide the basis for determining that a hazardous waste permit is not required under the federal Resource Con.verv~on and Recovery Act (RCRA) and the federal regulation~ adopted under RCRA ClZtle 40. Code of Federal Regulation~ (CFR)). Choose the re.a.von(s) that describe the open °f your on. rite ir?mint un~t~: · The hazardous w~.~ being uv.~tad is not a h~Ucras ~ ~ federal l~w although it is regulazed as a h,--rdous waste uacter Cali~mia staze law. The waste is u?.ated in wastewatc~ trcannent units (tanks), as defined in 40 CFR Part 260.10, and discharged to a publicly owned treannent woik~ (PC)TW)/sewcfing agency or under an NPDES permit. 40 CFR 264.1(g)(6) and 40 CFR 270.2. o Thc waste is treated ia elemeam7 aemralizazion ~mit,, as defued ia 40 CFR Pan 260.10. and discharged to a POTW/seweriag agency, or trader ~n NPDF, S permit, 40 CFR 264.1(g)(6) and 40 CFR 270.2. Th~ was~ U ur.~ed ia a zc~lly e,~c~c~mi u~ ~li~y as defizu~d ia 40 CFR l~rt 250. I0; 40 CFR 264~ 1 (g)(5). The compaay gez~ams ~ ~ ~i~ble.~ · ~-~~ ~t ~ ~ g~.-~ ~ ~rlO ~ ~"~ '~I.5. ~c w~ B ~ ~ ~ ~~ ~ ~ ~ ~6~ ~ ~s for ov~ 1~ ~/m~ ~~'~ 1~ or 270 ~s for g~ of to ~e M~ ~, 1~6 F~ '8. Recyclable ~,~i~ls ar~ rw.h/med to t~ov~ economically si_tn~ificant amounts of silver or other precious metals. 40 CFR 261.6(a)(2Xiv). 40 CFR 264.1(g)(2). and 40 CFR 266.?0. ]:-mpty container riasiag aad/or treatment. 40 CFR 261.7. TRANSPORTABLE TREA~ UNIT: NO [[~] Is this unit a Transportable Treatment Unit? Check Yes or No. PLease refer to the Instructions for more information. /f you answered yes, you must also complete and at*ach Form 1772E to thlc pl~e. DTSC 1772B (1/96) Page 12 Pete Wilson Governor Dep 'tment of Toxic Substances l l[ontrol Jesse R. Huff, Director 400 P Street, 4th Floor, P.O. Box 806 Sacramento, California 95812-0806 September 11, 1998 Peter M. Rooney Secretary for Environmental Protection Physicians Plaza Med Imaging Ctr Ioyce Ayers 4000 Physicians Blvd #101 Bakersfield, CA 93301 EPA ID: CAL000077802 For facility located at: 3700 Mall View Rd Bakersfield, CA 93306 DATE CLOSED: 09/25/97 Dear Onsite Treatment Facility: The Department of Toxic Substances Control (DTSC) has received your letter and/or notice informing DTSC and/or the California Board of Equalization (BOE) of the closure of your facility or treatment unit(s). Pursuant to your request, DTSC considers your treatment unit to be closed and no longer subject to the standards of your treatment authorization tier. DTSC will change your status in its Tiered Permitting database to "closed" and forward a copy of this letter to BOE for billing purposes. DTSC is acknowledging your closure letter because the closure date is prior to January 1, · 1998. Pursuant to Assembly Bill 1357, as of January 1, 1998, Certified Unified Program Agencies (CUPAs) are responsible for processing Conditionally Authorized and Conditionally Exempt notifications and closures. If you have re-located and continue to treat hazardous waste at the new site you need to (1) obtain an EPA ID number for the new site and, (2) submit an onsite treatment notification form to your local CUPA and a copy to DTSC. Please see the cc on page 2 for your local CUPA information. If there is no CUPA listed, your non-CUPA agency will be listed. (Continued on next page) California Environmental Protection Agency ~ Printed on Recycled Paper Physicians Plaza Med Imaging Ctr Page 2. EPA ID: CAL000077802 staff, CC; If you have any questions regarding this letter, please contact Ms. Marina Baiza, of my at (916) 322-0471. Sincerely, Sangat S. Kals, Section Chief Unified Program Section State Regulatory Program Division Mr. Ralph Huey Bakersfield City Fire Dept 1715 Chester Ave Bakersfield, CA 93301 (805) 326-3979 Stephen R. Rudd, Administrator Environmental Fees Division State Board of Equalization PO Box 942879 Sacramento, CA 942-0001 .S~ or California - Califorala Ea~iroam~ Agency Departmea~ of Toxic Substances Co-md Page 1 of ~7 ONSITE HAZARDOUS WASTI~ TREATMENT NOTIFICATION FORM FACILITY SPECIFIC NOTIFICATION For Use by Hazardous Waste Generators Performing Treatment ~ Under Conditional Exemption and Conditional Authorization, [] and by Permit By Rule Facilities [] Initial Renewal Revision Please refer to the attached Instructions before completing thix form. You may notify for more than one permitting tier by using this notification form, DT~C 1772. You must attach a separate unit specific notification form for each unit at this location. There are different unit specific notification forms for each of the four categorie, r and an additional notification forrn for transportable treatment units (TIU'$). You only have to submit forms for the tier(s} that cover your unit(s). Discard or recycle the other unused forms. Number each page of your completed notification package and indicate the total number of pages at the top of each page at the 'Page __ of__'. Put your EPA 1D Number on each page. Please provide all of the information requested; all fielda must be completed except those that state 'if different' or 'if available'. Please type the information provided on this form and any attachments. The notification fees are assessed on the basis of the number of tiers the notifier will operate under, and will be collected by the State Board of Equalization. DO NOT SEND YOUR FEE WITH THIS NOTIFICATION FORM. I. NOTIFICATION CATEGORIES Indicate the number of units you operate in each tier. This will also be the number of unit specific noti. fication forrns you must attach. Con~gitionally E. rzmpt Small Quantity Treatment operations may not operate units under any other tier. Number of units and attached unit specific notificat~o~"'.'.r~rted. A. Conditionally Exempt-Small Quantity Treatment B. 1 Conditionally ExemptoSpeclfied ~ast~estr~h~ Z ~ ,~o0~ :: ~E. ,,,. II. GENERATOR IDENTIFICATION EPA ID NUMBER CAL_.A 0, O O 0__ 7__7. 8 0 2 ~'~--R~L~UMBER 0 available) H Permit by Rule Commercial Laundry Variance (Section 25205.7) FACILITY NAME (DBA--Dolnl Bud~,~ A,) PHYSICAL LOCATION Physicians Plaza Medical Imaging Center-Kaiser East Hills 3700 Mall View Rd. Bakersfield Kern CA ZIP 93306 COUNTY CONTACT PERSON Joyce Ayers (Fu~ N~) ([aa PHONE NUMBER( 805 ).395 0155 MAILING ADDRESS, IFDIFFERENT: COMPANY NAME Physicians Plaza Medical Imaqinq Center STKE~F 4000 Physicians Blvd. ~101 CITY Bakersfield STATE CA ZIP 93301 .__ COUNTRY CONTACT PERSON Kern (only complete if not USA) Joyce Ayers (Fire Name) (Lam Name) PHONE NUMBER( 805 ) 395 DTSC 1772 (7194) Page 1 ' EPA ID NUMBER RADIOACTIV~ MATERIALS OR WASTE NO [] Does the facility use, store or treat radioactive materials or radioactive waste? Page, 2 of 7.~'5 IV. TYPE OF COMPANY: STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODE: Use either one or two SIC codes (a four digit number) that be. st describe your company's products, services, or industrial activity. Example: 7384 Photo~nishing lab 7218 Indus'trial la~ First: 8011 Offices & clinics of Second: 7384 Photofinishinq lab Medical doctors ¥. PRIOR PERMIT STATUS: Check yes or no to each question: YES NO El r'q l-'! l'~ 2. El 3. ["] ~1 4. El [3 5. PRIOR ENFORCEMENT H/STORY: YES NO Did you file a PBR Notice of Intent to Operate (DTSC Form 8462) in 1992 for this location? Do you now have or have you ever held a state or federal hazardous waste facility fullpermit, or interim status for any of these treatment units? Do you now have or have you ever held a state or federal full permit or interim status for any other hazardous waste activities at this location? Have you ever held a variance issued by the Department of Toxic Substances Control for the treatment you are now notifying for at this location'?. Has this location ever been instx:cted by the state or any local agency as a hazardous waste generator? Not required from generators only notifying as conditionally exempt or as a Within the last three years, has this facility been the subject of any convictions, judgments, settlements, or final orders resulting from an action by any local, state, or federal, environmental, hazardous waste, or public health enforcement agency? (For the purposes of this form, a notice of violation does not constitute an order and need not be reported unless it was not corrected and became a final order.) F1 If you answered Yes, check this box and attach a listing of convictions, judgments, settlements, or orders and a copy of the cover sheet from each document. (See the Instructions for more information) ATrAC'H2VIENTS: Attadune~ are not required for Commercial Lazuu~ facillties. 1. A plot plan/map detailing the location(s) of the covered unit(s) in relation to the facility boundaries. 2. A unit specific notification form for each unit to be covered at this location. DTSC 1772 (7/94) Page 2 · EPA ID NUMBER Page 3 of.7- CERTI17ICATIONS: This form must be signed by an authorized corporate oJ~cer or any other person in the company who has operational control and peoeorms decision-maMngfunclion.r that govern operation of the facility (per 77tie 22, California Code of Regulations (CCR) Section 66270.11}. All three copir_x mart have original Mgnatures. Wa.~t¢ Minimization I e~rtify that I have a program ia place to reduce thc volume, quantity, and toxicity of waste generated to the degree I have determined to bo economically practicable and that I have .~lected the practicable method of treatment, storage, or di~:~osal currently available to me which minimizes the pre. sent and future threat to human health and the environment. Tiered Permlttine Certification I certi~ that the unit or units described in the,s~ documents meet tho eligibility and operating requirements of state statutes and regulations for the indicated permitting tier, including generator and .~,ondary containment requiromcntn. I uader~tand that if any of the units operate under Permit by Rule or Conditional Authorization, I will also bo r~luired to provide required financial as.infantes by January I, 1995, and conduct a Pha~ I environmental asse~ment by January 1, 1995. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system d~igued to a.~ure that qualified personnel properly gather and evaluate the information submitted. Ba.~l on my inquiry of the person or per, oas who manage the system, or tho~ directly responsible for gathering the information, the information is, to the be~t of my knowledge and belief, true, accurate, and complete. I am aware that there are subsumtial penalti~ for submitting false information, including the possibility of f'm~ and imprisonment. for knowing violations. Jerry Sturz Name (Print or Type) Signature Date Signed Title OPERATING REQUIREMENTS: Please note that generators treating hazardous waste onsite are required to comply with a number of operating requirements Which differ depending on the tier(s). ~7~ese operating requirements are set forth in the statutes and regulations, some of which are referenced in the 7~er-~pecific Fact Sheets available.from the Department's regional and headquarters o. ffices. SUBMISSION PROCEDURe: You must ~.u~.mit..t~,q copie~ of this completed notification by certified mail, return receipt requested, to: Department of Toxic Substances Control Onsite Hazardous Waste Treatment Unit 400 P Street, 4th Floor (walk in only) P.O. Box S06 Sacramento, CA 95812-0806. You must also ~rnit one cop~ of the notification and attachments to the local regulatory agency in your jurisdiction as listed in Appendix 2 of the instruction materials. You must also retain a copy as part of your operating record. .dH three forms must tuxve original signature, not photocopies. DTSC I772 (7/94) Page 3 EPA ID NUMBER CONDITIONALLY EXEMPT - SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) Page4__of7 'I'ne Tier-.Sp .' ~c Fact Sheets contain a smnmary of the operating requirements for this category. Please review those requirements carefully before completing or submitting this notification package. UNIT NAME Si lvmr l~omlm~mor UNIT ID NUMBER 1 NUMBER OF TREATMENT DEVICES: 1 Tank(s) 1 Container(s)/Container Treatment Area(s) Each unit must be clearly identified and labeled on the plot plan attached to Form 1772. Assign your own unique number to each unit. The number can be sequential (I, 2, 3) or using any system you choose. Enter the estimated monthly total volume of hazardous waste treated by this unit. This should be the maximum or highest amount treated in any month. Indicate in the narrative (Section II) if your operations have seasonal variations. L YES E! WASTESTREAMS AND TREA~ PROCESSES: Estimated Monthly Total Volume Treated: NO [] Is the waste treated in this unit radioactive? pounds and/or 29 gallons Is the waste treated in this unit a bio-hazard/infectious/medical waste? El El n The following are the eligible wastestreams and treatment processes. Please check all applicable boxes: 1. Treats resins m'.txed in accordance with the manufacturer's instructions. Treat containers of 110 gallons or less opacity that contained haTardous waste by rinsing or physical processes, such as crushing, shredding, grinding, or puncturing. Drying special wastes, as classified by the department pursuant to Title 22, CCR, Section 66261.124, by pressing or by passive or heat-aided evaporation to remove water. Magnetic separation or screening to remove components from special waste, as classified by the deparhiient pursuant to Title 22, CCR, Section 66261.124. Neutralize acidic or alkaline (base) wastes from the regeneration of ion exchange media used to demineralize water. (This waste cannot contain more than 10 percent acid or base by weight to be eligible for conditional exemption.) 6. Neutralize acidic or alkaline (base) wastes from the food processing industry. Recovery of silver from photofinishing. The volume limit for conditional exemption is S00 gallons per generator (at the same location) in any calendar month. DTSC 1772B (7/94) Page 10 EPA ID NUMBER CRL CONDITIONALLY EXEMPT - SPECIFIED WASTESTREAMS · UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) Page 5 of, [51 r-1 II. Gravity separation of the following, induding the use of flocculants and demulsifiers if a. The settling of solids from the waste where the re~altiag aqueous/liquid stream is not hazardous. b. The separation of oil/water mixtures and separation sludges, if the average oil recovered per month is less than 25 barrels (42 gallons per barrel). Neutralizing acidic or alkaline (base) material by a state certified laboratory or a laboratory operated by an educational institution. (To be eligible for conditional exemption, this waste cannot contain more than 10 percent acid or base by weight.) 10. Hazardous waste treatment is carried out in quality control or quality assurance laboratory at a facility that is not an offsite hazardous waste facility. 11. A wastestream and treatment technology combination certified by the Department pursuant to Section 25200.15 of the Health and Safety Code. NARRATIVE DESCRIPTIONS: Provide a brief description of the specific waste treated and the treatment process used. 1. SPECIFIC WASTE TYPES TREATED: pbo'eo Fi×~r ~on~-~ 2. TREATMENT PROCESS(ES) USED: Electrolytic and Metallic Replac~m~n~ Fl RESIDUAL MANAGEMENT: Check Yes or No to each question as it applies to all residuab from this treatment unit. NO ['"! 1. Do you discharge non-haTardous aqueous waste to a publicly owned treatment works (POTW)/sewer? 2. Do you discharge non-baTardous aqueous waste under an NPDES permit? Do you have your residual buTardous waste hauled offsite by a registered hazardous waste hauler? If you do, where is the waste sent? Check all that apply. I~i a.' Offsite recycling I~l b. Thermal treatment I-I ¢. Disposal to land I'"! d. Further treatment ['~ 4. Do you dispose of non-hazardous solid waste residues at aa offsite location? I~! 5. Other method of disposal. Specify: DT$C 1772B (7/94) Page 11 EPA ID NUMBER CAL ~02 CONDITIONALLY EXEI~fI"T - SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) Page 8__ of _7 IV. BASIS FOR NOT NEEDING A FEDERAL PERMIT: In order to demonstrate eligibility for one of the onsite treatment tiers,facilitie, s are required to provide the basis for determining that a hazardous waste per,nit is not required under the federal Re. source Conservation and Recovery Act (RCRA) and the federal regulations adopted under RCRA ('JTtle 40, Code of Federal Regulations (CFR)}. Choose the reason(s} that de. scribe the operation of your onsite treatment units: [-] I. The ha?ardous waste being treated is not a hazardous waste under federal law although it is regulated as a h-7ardous waste under California state law. The waste is treated in wastewater treatment units (tanks), as defined in 40 CFR Part 260.10, and discharged to a publicly owned treatment works (POTW)/sewcring agency or under an N'PDES permit. 40 CFR 264. l(g)(6) and 40 CFR 270.2. The waste is treated in elementary neutralization units, as defined in 40 CFR Part 260.10, and discharged to a POTW/sewering agency or under an NPDES permit. 40 CFR 264. l(g)(6) and 40 CFR 270.2. The waste is treated in a totally enclosed treatment facility as defined in 40 CFR Part 260.10; 40 CFR 264.1(g)(5). !-I 6. The company generat~ no more than 100 kg (approximately 27 gallons) of hazardous waste in a calendar month and is eligible as a federal conditionally exempt small quantity generator. 40 CFR 260.10 and 40 CFR 261.5. The waste is treated in an accumulation tank or container within 90 days for over 1000 kg/month generators and 180 or 270 days for generators of 100 to 1000 kg/month. 40 CFR 262.34, 40 CFR 270. l(c)(2)(i), and the Preamble to the Maroh 24, 1986 Federal Register. · Recyclable materials are reclaimed to recover economically significant amounts of silver or other precious metals. 40 CFR 261.6(a)(2)(iv), 40 CFR 264. l(g)(2), and 40 CFR 266.70. Empty container rinsing and/or treatment. 40 CFR 261.7. l-'i 9. Other. Specify:. V. TRANSPORTABLE TREATMENT UNIT: YES NO El ISI Check Y~ or No. Please refer to the Instructions for more information. Is this unit a Transportable Treatment Unit? It' you answered yes, you must also complete and attach Form 1772E to this page. DTSC 1772B (7/94) Page 12 EPA ID N[~4R~r~ %CAL000077802 Hwy 178 Page.,7 of 7 PLOT PLAN Physicians Plaza Medical Imaging Center c/o Kaiser Permanente East Hills (01 Mall View Rd. kersfield, CA 93306 05) 334-2982 (facility) (805) 395-0155 (contact person) LOBBY Processor(A) Silver Reclaimer (B) ~ S~ilye.r' ,_, ~ i ~ canls~ers~u) I _i Drain :Mall View Road . Stye or Calito~. Calltornla gnviromn~ec6oa A~enc~ Deparunaa ot Toxic ~bstano- C3~rot Page I of,.~. ONSITE HAZARDOUS WASTE TREATME NOTIFICATION FORM FACILITY SPECIFIC NOTIFICATION _ For Usa by Ha:,a_,xtoua Was~ Ocucrator~ Performi,g Treatment [] Initial Under Conditional Exemption and Conditional Authorization, [] Renewal nnd by Permit By Rule Facilitiem [] Amendment J>leaxe r~fer to the attached ltutruction~ b~eore completing thix form. You may notify for more than one permitting tier by u~ing thi, notification form, DFC 1772. You mu~t attach a separate unit Jj>ecific notification form for each unit at thtr location. There are different una specific notificat(on forrn~ for each of the four categorie, r and an additional notification form for transportable treatment uni= (TIEI's). You only have'to submit forrnr for the tier(z) that cover your unit(z). Discard or recycle the other unu~ed formr. Number each page of your completed notification package and indicate the total number of pag.~, at the top of each page at the 'Page__ of__: Put your EPA ID Number on each page. Please provide all of the information requested; all fieldr mart be completed except those that ~tate 'if different' or 'if availablt'. Please type the information provided on thtr form and any attachments. ~e notification feg~ are asse.rsed on the basi~ of the number of tier~ the notifier will operate under, an~ will be collected by the State Board of Equalization. DO 3107' SEND I~OUR FEE WITH THIS NOTIYTCA7'[031 FORM. L NOTIFICATION CATEGORIF~ Indicate the number of uni= you operate in each tier. 2'htr will also be the number of unit specific notification forrttr you must attach. Conditionally F_xtn~ ~ll Quantity Tre. atmt~ operationx may not operate ~ under any other tier. Number of units and attached unit specific notifications for each tier reported. A. Conditionally Exempt-Small Quaatity Treatment D. Permit by Rule B. 1 Conditionally Exempt-Specified Wa.st~tream E. Commercial iaundry C. Cond/tionally Authorized F. Variance (Section 25143) H. GENERATOR IDENTIFICATION EPA ID NUMBER CAL 0 'FACILITY NAME (DBA-Doing ~haa/ne~ A~) PHYSICAL LOCATION 0 0 0 7 7 ~__.02__ BOE NUMBER (ifavailable) H__HQ._ ....... Ph}rsicians Plaza Medical Imaqinq Center/ East Hills Kaiser 3700~.11 View Road crrY COUNTY Bakersfield CA ZIP 93306 Kern CONTACT PERSON Jolrce . .. A]rer$ MAILING ADDRESS, IF DIFFERENT: COMPANY NAME Phlrsicians CITY COUNTRY CONTACT PERSON NUMBER( 805 ) 395 -m Plaza Medi~al Tmag~ng 4000 Physicians Blvd ~101 Bakersfi~%d STATE CA ZIP 9330l For DT$C U~ Only Rcglon (only complctc it' not USA) Joyce Ayers (First Name) (Last Name) PHONE NUMBER( 805)_ DTSC 1772 (1/95) Page I CONDITIONALLY EXEMFr - SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code S~ction 25201.5(c)) Page __~ of~ The Tier-Specific Fact Sheets contain a stmunary of the operatln~ requirements for this category. Please review those requirements carefully before completing or submitting thin notification package. UN1TNAM~ Silver Reclaimer NUM]~ER OF TREATMENT DEVICES: 0 Tank(s) 2 Contaiaer(s)/Container Treatment Area(s) NUM3ER OF STORAGE DEVICES: 0 Tank(s) Each unit must be clearly identified and labeled on the plot plan attached to Form 1772. Assign your own unique number to each unit. The number can be sequential (1, 2. $) or using any system you choose. Enter the estimated monthly total volume of hazardou~ waste treated by this unit. This should be the madmum or highext amount treated 'in any month. Indicate in the narrative (Section I1) if yo. ur operation~ have seasonal variatiorav. ~ Estimated Monthly Total Volume Treated: pounds and/or 29 gallons Estimated Monthly Total Volume Stored: pounds and/or 0 gallons YES NO Is the waste treated in this unit radioactive? Is the waste treated in this unit a bio-b.~z~rd/infectious/medical waste? Is remotely generated hazardous waste (HSC 2~110.10) treated ia this t~uit? The following are the eligible wustestrearns and treatment processes. Please check all applicable boxes: 2. 3. 4. Treats reslhs mixed or cured in accordance with the manufacturer's instructions (including one-part .and pre-impregnated materials). Treat containers of 110 gallons or less capacity that contained bn?nrdous waste by rinsing or physical processes, such as crushing, shredding, grinding, or puncturing. Drying special wastes, as classified by the department pursuant to Title 22, CCR, Section 66261.124, by pressing or by passive or heat-aided evaporation to remove water. Magnetic separation or screening to remove components from special waste, as classified by the depaxhnent pursuant to Title 22, CCR, Section 66261.124. *NOTE* [-] 6. 5. NO AU'I~ORIZATION IS NEEDED to neutrai;~ acidic or alkaline (base) wastes from ~ regeaeration of ion exctmnge media used to dt-m;nea-allze water. (This waste cannot coota;- more than 10 percamt acid or base by weight to be eligible for this exemption.) Neutralize acidic or alkaline (base) wastes from the food processing industry. Recovery of silver from photofinishing. The volume limit for conditional exemption ls 500 gallons per generator (at the same location) in any calendar month. *NOTE* Recovery of 10 gallons or less per month of silver from photofinishing is completely exempt from permitting; this form need not be submitted. DTSC 1772B (1/95) Page 10 EPA iD NUMBER Page 3 of '_~ CERTIFICATIONS: This form must be $igned by an authorized corporate officer or any other person in the company who has operational control and perfonn$ decision-making functions that govern operation of the facility (per 2~tle 22, Califof'nia Code of R. egulations (CCR) Section 66270.11). All three copi~ mu~ have original ~igmmwe~. . Waste Minimization I certify that I have a program in place to reduce the volume, quantity, and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the pre.nent and furore threat to human health and the eaviromnent. Tiered Permittine Certification I certify that the unit or units described ia these documents meet the eligibility and operating requirements of state statutes and regulations for the indicated permitting tier, including generator and secondary containment requirements. I understand that if any of the units operate under Permit by Rule or Conditional Authorization, I w/Il also be required to provide requ/red financial assurance for closure of the treatment un/t by January 1, 199:5. I certify under penalty of law that this documentand ail attachments were prepared under my direction or supervision in accordance with a system de$igaed to a.~'um that qualified persoanel properly gather and evaluate the information submitted. Ba.~i on my iaquiry of the person or persons who manage the system, or thos~ directly responsible for gathering the information, the information is, to the beat of my knowledge and belief, true, accurate, and complete. : I am aware that ther~ are substantial penalties for submitting fal.~ information, including the possibility of fines and imprisonm,~t. for knowing violations. Jerrxr Sturz Name (Print or Type) Signature Admi ni Title Date Signed OPERATING REQUIREMENTS: Please note that generators treating hazardous waste onsite are required to comply with a number of operating requirement~ which differ depending on the tier(s). These operating requirements are set forth in the statutes and regulations, some of which are referenced in the ~er-$pecific Fact Sheets available from the Department's regional and headquarters o.~ces. SUBMISSION PROCEDURES: You must submit two copier of this completed notification by certified mail, return receipt requested, to: Department of Toxic Substances Control Program Data Management Section xtra t> ~ ..... ,t,t, Ft. oorr&m~nv~j~alk in only) P.O. Box 806 Sacramento, CA 95812-0806. You must also submit one copy of the notification and attachments to the local regulatory agency in your jurisdiction as li~ted in Appendix 2 of the instruction materials. You must also retain a copy as part of your operating record. All three forms must have original signatures, not photocopies. DTSC 1772 (1/95) 'Page 3 STATi; OF CAUF~RNIA-ENVIRONMENTAL PROTECTION AGENCY DEPARTMENT OF TOXIC ~ES CONTROL REGION 1-1515 Toilhou~ Road Cloy/s, CA ~J612 C~CKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers NOTE SHEET PETE Wl/.SON, Governor This sheet includes inspector observations and expands upon the violations identified on the checklist (by number). In some cases, it indicates how the facility should correct the violations. It also includes the names of any others participating in this inspection. Onsite Checklist (D) Page of Au~.tst 2, 1994 STATE OF CALIFORNIA---CAUFORNIA ENVIRONM~ AGENCY s s ^.c s 400 P STREET, 4TH FLOOR P.O. BOX 806 SACRAMENTO, CA 95812-0806 (916) 323-5871 - CONTROL· 01/17/95 EPA ID: CAIX}00077802 PHYSICIANS PLAZA MED IMAGING CTR JOYCE AYERS 4000 PHYSICIANS BL #101 .BAKERSFIELD, CA 93301 3700 MAI.I. VIEW RD BAKERSFIELD, CA 93306 Authorization Date: 01/17/95 Dear Conditionally Authorized and/or Conditionally Exempt Facility: ACKNOWLEDGEMENT OF UNITS OPERATING UNDER CONDITIONAL AUTHORIZATION AND/OR CONDITIONAL EXEMPTION The Department of Toxic Substances Control (DTSC) has received your 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 ~lrninistratively 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 subject to penalty if violations of laws or regulations are found. The Depa~ment acknowledges receipt of your comple~__~l_ notification for the treatment unit(s) listed on the last page of this letter. These units operating under Conditional Authorization or Conditional Exemption are nuthorized 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 annual fees calculated on a calendar year basis for each year you operate and have not notified DTSC that the units have been closed. You must notify the DTSC 60 days before first treating hn~n~dous 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 misnam~mtstion or any failure to fully disclose all relevant, facts shah 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 fw:ilities later this year. "-' Page 2 EPA ID: CAL000077802 If you have any questions regarding this letter, or have questions on operating requirements for your facility, please contact the nearest DTSC regional office, or this ofliee at the letterhead address or phone number. Enclosure ASTRID JOHNSON DTSC REGION 1 STATE REGULATORY PROGRAM 1515 TOLLHOUSE CLOVIS, CA '93611 Michael S. Homer, Chief Onsite HnTnrdous Waste Treatment Unit Permit Streamlining Branch Hazardous Waste Management Program STEVE MCCALLEY KERN COUNTY ENVIRON. HEALTH SERVICES DEPT 2700 M STREET, SUITE 300 BAKERSFIELD, CA 93301 Page 3 ENCLOSURE 1 t/n/ti tmOtor/z~ to o~rate at th/s/ocat/on.- UNDER CONDITIONAL AUTHORIZATION: EPA iD: C~77802 UNDER CONDITIONAL EXEMI~TION: 1 '- ~TATE OF CA~NVIRONMEN ~ROTECTION AGENCY omc sus _ REGiOI~ 1-1515 Toilhous~ Road - Clo~s. CA 93612~ CHECK~.I.qT AND INSPECTION REPORT FOR Pe,mit by Rule, Conditionally Authorized, and Conditionnlly Exempt Notifiers FACILITY NAME: ?~ ~/s~ PHYSICAL ADDRESS: COUNTY ~-,~ ~ FACILITY CONTACr-NAME: UNIT COUNT: PBR UNIT COUNT(nolified)i PBR INSPECTION DATE: /%,,.; / q VIOLATION TYPE: NOTICE to COMPLY ISSUHD (y/n): This checklis~ and impecfion report idemify violafious of sia~e law regarding ousi~ trmters of hazardous waste, opem~-g under an oasite permitiiug ger. This im'lX, cgon verilks the information provided on form DTSC 1772. It also covers generator requirements, .Irhough a separam checldis~ may b~ used for tho.~ requlremems. A checlmmrk indicates violation of the law, which are explained in more detail on the attached note sheets and N~fice to Comply. The governing laws are the Health and Safety Code (HSC) and T'~le 2~ of the California Code of ReSulations (22 CCR). Generator Standards: Each in. rpecrion agency may u~¢ their own generator inspection cbecklivt or protocolr, which are ~nvnarized below. ,4 full evaluation of each item or document ir not comtuc~d during the In~ecrkrn, unless $erio~ de. ficienc~ are zuzpected. 1.O/i COntingency plan has been Prepared (adequately minimize releases, has alarm/communication system., lists emergency equipment and phone numbers for emergency coordinators). 2.0 ~ Written training doc-ments and records prepared for employees handling hazardous waste. 3. ~_ Meet container wnn~gement standards (storage time limits, closed, labelled, compatibility, inspected weekly, in good condition, with ignitable.~/reactives 50 feet from property line). 4.//fl Meet tank management standards (either secondary containment or integrity assessments, plus storage time limits, labelled, compatibility, inspected daily, in good condition, with ignitables/reactives 50 feet from property line). 5.0t All wastes are properly identified. Treatment Items-Facility Wide: (Facility mu~t aubmit a revises Form 1772 to co,fete e~ro~ or omissions.) 6./)~. All units under PBR, CA, and CE are properly indicated on Form DTSC 1772. (Add any new units with unit sheets or correct tier on the unit sheet.) 7.0A · All generator identification information on Form DTSC 1772 is correct. 8.0/% 'The submitted plot plan/nmp adequately shows the location of all regulated units. · 9. ~L There are records documenting compliance with sewer agency pretreatment standards and industrial waste discharge requirements, where applicable: 10./~//~ Generator has prepared/maintained source reduction documents requirements (SB 14/SB 1726). For many wastes, a checklist or plan is required only if annual hazardous waste volume is over 5,000 kilograms (approx 11,000 pounds or 1,350 gallons). HSC 25244.15, 25244.19-.21 For CA or PBR notifiers: 11. ~# The generator has an annual waste minimization certification. (PBR submit with renewals.) Onsite Checklist (A) Page 1 of / January 1, 1995 STAT~ OF CALIFORNIA~ENVIRONMENTAL PROTECTION AGENCY DEPARTMENT OF TOXIC SUB.',~F)NcES REGION 1-1515 Tollhouse Road Clovis, CA 93612 CONTROL CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR Permit by Rule, Conditionally AuthOrized, and Conditionally Exempt Notifiers UNIT SHEET PETE WILSON, Governor Complete one unit sheet for each Unit either listed in the notification or identified during the inspection. · Unit N-tuber: / Unit Name: Notified Tier: c ~'~ ~ Correct Tier:. Notified Device Count: Correct Device Count: Tanks / Containers Tank~ (~ Containers For each Unit: NC} 12.o~ 13. 14. v~ 15. 16. 17. 18. 19. 20. 21. 22 23. All hazardous wastes treated are generated onsite. The unit notification is accurate as to the number of tank(s) and/or Container(s). The estimated notification monthly treatment vblume is appropriate for the indicated tier. The waste identification/evaluation is appropriate for the tier indicated. The wastestream(s) given on the notification form are appropriate for the tier. The treatment process(es) given on the notification form are appropriate for the tier. The residuals management information on the form is correct and documented for the unit. The indicated basis for not needing a federal permit on the notification form is correct. There are written operating instructions and a record of the dates, volumes, residual management, and types of wastes treated in the unit. There is a written inspection schedule (containers-weekly and tanks-daily). There is a written inspection log maintained of the inspections conducted. 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.p//TThe g~nerator has secondary containment for treatment in containers. For each PBR unit: 25.~/~ There is a waste analysis plan 26.f/'' There are waste analysis records. 27. There is a closure plan for the unit. Unit Comments/Observations: (If this is a unit that was not incluaed on the notification form, the violation is operating without a perrnit-HSC 25201(a). Also note if the activity is currently ineligible for onsite authorization.) Onsite Checklist (B) Page / of t Ianuary 1, 1995 :'STATE'OF CALIFORNIA-ENVIRONMENTAL PROTECTION AGENCY 'DEPARTMENT OF TOXIC S~ CONTROL R~GION 1-1515 Tolllmus~ Road Clovis, .CA~ 93612' CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT_ FOR Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers SIGNATURE S~ET Onsite Recycling: Only answer if th~ facility recycles more than 100 kilograms/month of hazardous waste on, ire. NO '28. _The apPropriaie local agency has been notified. H$C 25143.I0 29./V/~Acdvides claimed under the onsite recycling exemption are appropriate. H$C 25143.2 et sec. Releases: YES If there has been a release, provide the following information: number of releases, date(x), type(s) and quantity of material~/wuste, and the cause(s). Use unit sheet or attach additional pages. Within the last three years, were there any unauthorized or acddental releases.to the environment of hazardous waste or hazardous waste constituents from onsite treatment units? 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: Print Name:/~ Tide: //~ 2- Agency: Phone Number: Other Inspector: Signature: Print Name: Title: Agency: Phone Number: Facility RePresentative: Your signature aclmowledges receipt of this report and does no~t.'unply agreement with the f'mdings. -, · ._L · Onsite Checklist (C) Page / of I August 2, 1994 STATE OF CALIFORNIA-ENVIRONME~%L PROTECTION AGENcy DEPARTMENT OF TOXIC SUb~.~ ANCES CON"f~/OL REGION 1--1515 Tollhouse Road Clovis, CA 93612 TII~'~RI~'J~ P~RM~TTING P£¥E WILSON, Governo, C~R'I'Ilq'CATION OF RETURN TO COM'PLIAN~F, For Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers .770 o ~,~ / / p,) ;~ ~_~ In the matter of the Violation cited on: ~ As Identified in the Inspection Report dated Conducted by' Department of Toxic Substances Control (agency(s)) I certify under penalty of law that: 1. Respondent has corrected the violations specified in the notice of violation cited above. I have personally examined any documentation attached to the certification to establish that the violations have been corrected. 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. I am authorized to file this certification on behalf of the Respondent. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Joyce D. Asrers Name (Print or T~,e) Signatu e ~ - Physicxans Plaza Medical Imaging Center 'Company Name Chief Technologist Tide Date Signed CAL000077802 EPA ID. Number DTSC-RETCOMP.CRT (8/94) STATE OF CALIFORNIA-ENVIRONr~'~ITAL PROTECTION AGENCY DEPARTMENT OF TOXIC St.~'~TANCES CONTROL REGION 1-1515 Tollhouse Road Clovis, CA 93612 C~RTI'~_CATION OF RET[JRN TO ~OMpT,TANCR PETE WILSON, Governc, ' For Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers 3'70 o ,% / / In the matter of the Violation cited on' ~/ As Identified in the Inspection Report dated Conducted by ' Department of Toxic Substances Control (agency(s)) I certify under penalty of law that: Respondent has corrected the violations specified in the notice of violation cited above. e I have personally examined any documentation attached to the certification to establish that the violations have been corrected. Based on my examination of the attached documentation and inquiry of the individuals who prepared or obtained it, I beiieve that the information is tree, accurate, and complete. I am authorized to file this certification on behalf of the Respondent. t I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Joyce D. Ayers Name (Print or Physicians Plaza Medical Imaging Center 'Company Name Chief Technologist Tide Date Signed CAL000077802 EPA ID. Number DTSC-P. ETCOMP.CRT (8/94) - Sta~ of Cal~om[a - Cal~or~a Eavlrom~ Protecfio~ Ateuc), l)epartmemt of Tox~ Su/~a~ Contr~ Pag~ 1 of~ ONSITE HAZARDOUS WASTE TREATME 'NOTIFICATION FORM FACILITY SPECIFIC NOTIFICATION For Usa by Ha,~_nio~ Wa.sm Generators Performing Tr~atmen¢ l"l Initial Under Conditional Exemption and Condi6om~l Authorization, a~d by Permit By Rule Facilities [] Amendment Please refer to the attached Insrruaions before completing this form. You may notify for more than one permitting tier by u~ing this natification form, DT~C 1772. You must attach a separate unit specific notification form for each unit at this location. There are different una specific notification form~ for each of the four categories and an additional notification form for transportable treatment unit~ ~Ttf's). You only have'to sabmit forms for the tier(s) that cover your unit(s}. Discard or recycle the othtr unat~d form~. Number each page of your completed notification package and indicate the total number of pag~ at the top of each page at the 'Page ~ of __: Put your EPA iD Number on each page. Please provide all of the inforrnat(on requested; all field~ must be completed except those that ~tate 'if different' or 'if available'. Please type the information provided on this form and any attachrnent~. 27re notification fees are assessed on the basis of the number of tiers the notifier will operate under, an~ will be collected by the State Board of Equalization. DO NOT SEND YOtfR ~ ~ 77tls NO7'I~C~ITION FORM. L NOTIFICATION CATEGORIES Indicate the number of units you operate in each tier. Thix will also be the number of unit xpecific noti~cation forms you must attach. Conditionally Extmpt Small Quantity Treatme~ operations may not operate units under any othtr tier. Number of unitz and attached unit specific notifications for each tier reported. A. Conditionally Exempt-Small Qurmtity Treatment D. Permit by Rule B. 1 Conditionally Exempt-Specified Waste.stream E. C. Cunditiomally Authorized F. Commercial Laundry Variance (Section 25143) H. GENERATOR IDENTIFICATION EPA ID NUMBER CAL 0 'FACILITY NAME (DBA-Doing Bu,;ne,- Aa) PHYSICAL LOCATION 0 0 0__7__7__8_Q_2__ BOE NUMBER (ifavailable) H__HQ__. Physicians Plaza Medical Imaqinq Center/ East Hills Kaiser 3700 ~11 View Road CITY :' Bakersfield Kern CA ZIP 93306 - COUNTY CONTACT PERSON Jo}rce . . Ayers PHONE NUMBER( 805 )395-0'~ 55 MAILING ADDRESS, ,IF DIFFERENT: COMPANY NAME Physicians Plaza Medimal Tam,lng a~n~.or STREET 4000 Physicians Blvd ~101 CITY Bokersfie%~ · STATE O_A ZIP 93301 For DT$C U~ Only Region __ COUNTRY CONTACT PERSON (only complcu: if not USA) Joyce Ayers 05t~t Name) (last Name) PHONE NUMBER( 805~__3.q__5__' 0~ 55 DTSC 1772 (1/95) Page I E?A ID NUMBER. CONDITIONALLY EXEMFr - SPECIFIED WASTESTREAMS UNIT SPECI3~IC NOTIYlCATION (pursuant to Health and Safety Code S&:fiou 25201.5(c)) The Tier Specific Fact Sheets contain a s. mmary of the operating requirements for this category. Please review those requirements carefully before completing or submitting this notification package. UN1TN~ Silver Reclaimer NUNIBER OF TREATMENT DEVICES: 0 Ta~(s) 2 Coutainer(s)/Cout-iner Treatment Area(s) NIJM~ OF STORAGE DEVICF~: 0 Tank(s) Each unit must be clearly'identified and labeled on the plot plan attached to Form 1772. Assign your own unique number to each unit. The number can be sequential (1, 2. $) or using any system you choose. Enter the ~timated monthly total volume of hazardous waste treated by this unit. This should be the ma~mum or highest amount treated 'in any month. Indicate in the narrative (Section IX} if yo. ur operations have ~eusonal variations. Estimated Monthly Total Volume Treated: Estimated Monthly Total Volume Stored: pounds and/or 29 gallons pounds and/or 0 gallons YES NO Is the waste treated in this unit radioactive? Is the waste treated in this unit a. bio-},a:~ard/infectious/medical waste? Is remotely generated hazardous waste (HSC 25i 10.10) treated in this unit7 The following are the eligible wastestreams and treatment processes. Please check all applicable boxes: 2. 3. 4. Treats resihs mixed or cured in accordance with the manufacturer's instructions (including one-part ,and pre-impregnated materials). Treat containers of 110 gallons or less capacity that contained hazardous waste by rinsing or physical processes, such as crushing, shredding, grinding, or puncturing. Drying special wastes, as classified by the depa~U,ent pursuant to Title 22, CCR, Section 66261.12A, by pressing or by passive or heat-aided evaporation to remove water. Magnetic separation or screening to remove components from special waste, as classified by the depaxh,tent pursuant to Title 22, CCR, Section 66261.124. *NOTE* $. NO AUTHORIZATION lS NEEDED to neutrally- acidic or alkaline (base) wastes from the regeneration of ion exchange media used to deminerallze water. (This waste cannot contain more than 10 percent acid or base by weight to be etign'ble for this exemption.) Heutralize acidic or alkaline (base) wastes from the food processing industry. Recovery of silver from photofinishing. The volume limit for conditional exemption is 500 gallons per generator (at the same location) in any calendar month. *NOTE* Recovery of 10 gallons or less per month of silver from completely exempt from permitting; this form need not be submitted. photofinlsbing is DTSC 1772B (1/95) Page 10 EPA ID NUMBER Page 3 of-~ CERTIFICATIONS: This form must be signed by an authorized corporate officer or any other person in the company who her operational control and perforrnz decision-making functions that govern operation of the facility (per 2~tle 22, Califoinia Code of R. egulations (CCR) Section 66270. I1). All three cvpies mart have original zignafltres. . W~te Minimization I certify that I have a program in place to reduce the volume, quantity, and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the pre.~nt a~d future threat to human health and the environnmnt. Tiered Permitting Certification I certify that the uait or units described ia these documeats meet the eligibility and operating requirements of state statutes and regulations for the indicated permitting tier, including generator and secondary containment requirements. I understand that if any of the un/ts operate under Permit by Rule or Cond/t/onal Authorization, I will:also be requ/red to provide required finaacial assistance for closure of the treatment unit by January 1, 1995. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system desigaed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those directly responsible for gathering the information, the information is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are substantial penalties for submitting false information, including the possibility of fines and imprisoament. for knowing violations. Jerr3_r Sturz Name (Print or TYI~) Signature Title OPERATING REQUIREM~ENTS: Plea. re note that generators treating ha:.ardous wuste onsite are required to comply witlf a number of operating requirement~ which di2~ter depending on the tier(s). These operating requirements are set forth in the ~tatutex and regulations, some of which are referenced in the 22er-Specific Fact Sheets available from the Department's regional and headquarters o~ce~. SUBMISSION PROCEDURES: .You must submit tree copies of this completed notification by certidqed mail, return receipt requested, to: Department of Toxic Substances Control Program Data Management Section ~53-~a& in only) P. O. Box 806 Sacramento, CA 95812-0806. You must also submit one copy of the notification and attachments to the local regulatory agency in your jurisdiction as listed in Appendix 2 of the instruction materials. You must also retain a copy as part of your operating record. All three forms must have ori~tinal signatures, not photocopie, v. DTSC 1772 (I/95) 'Page 3 S~ate of Calffomh. Ca~U'ora~ EaHroam Departmem of Toxic Sui~,,,'~ Contrd Page 1 of 7~ ONSITE HAZARDOUS WASTI . TREATMENT NOTIFICATION FORM FACILITY SPECIFIC NOTIFICATION For Use by Hazardous Waste Generators Performing Treatment ~ Under Conditional Exemption and Conditional Authorization, [] and by Permit By Rule Facilities [] Initial Renewal Revision Please refer to the attached Instructions before completing this form. You may notify for more than one permitting tier by using this notification form, DTSC 1772. You must attach a separate unit specific notification form for each unit at this location. There are different unit specific notification forrn~ for each of the four categories and an _,,dditional notification form for transportable treatment units fITU's). You only have to submit forms for the tier(s} thal cover your unit(s). Discard or recycle the other unused forms. Number each page of your completed notification package and indicate the total number of pages at the top of each page at the 'Page __ of__: Put your EPA ID Number on each page. Please provide all of the information requested; all field~ must be completed except those that state 'if different' or 'if available'. Please type the information provided on this form and any attachments. The notification fees are assessed on the basis of the number of tiers the notifier will operate under, and will be collected by the State Board of Equalization. DO NOT SEND YOUR FEE WITH T17I$ NO77FICATION FORM. I. NOTIFICATION CATEGORIES Indic. ate the number of units you operate in each tier. This will also be the number of unit specific notification forms you must attach. Conditionally Extmt~ Small Quantity Tremrntnt operation~ may not operate ~ under any othtr tier. Number of units and attached unit specific notifications for each tier reported. A. Conditionally Exempt-Small Quantity Treatment D. . ....Permit by Rule B. 1 - Conditionally Exempt-Specified Wastestream E. Commercial laundry C. Conditionally Authorized F. Variance (Section 25205.7) II. GENERATOR IDENTIFICATION EPA ID NUMBER ~AL_2 O_tO .0 0 7 7 8 0 2 BOE NUMBER (if available)H__HQ.._. FACILITY NAME Physicians Plaza Medical Ima~in~ Center-Kaiser East Hills (DBA-Doing Busincsa As) PHYSICAL LOCATION 3700 Mall View Rd. CITY Bakersfield CA ZIP 93306 COUNTY , Kern CONTACT PERSON Joyce Ayers PHONE NUMBER( 805 )-395 - 0155 MAH.INGADDRESS, IFDIFFERENT: COMPANY NAME Physicians Plaza Medical Imaqinq Center STI~E~ 4000 Physicians Blvd. ~101 CITY Bakersfield STATE CA ZIP 93301 COUNTKY CONTACT PERSON Kern (only complete if not USA) Jo¥ce Ayers (Fire Name) (LaM Name) PHONE NUMBER( 805 ) 395 DTSC 1772 (7194) Page 1 EPA ID NUMBER CAL 0000' page f of 7._ RADIOACT/VE MA~~ OR WASTE NO ['~ Does the facility use, store or treat radioactive materials or radioactive waste? IV. TYPE OF CONfPANY: STANDARD INDUSTRIAL CLASSI3"ICATION (SIC) CODE: Use either one or two SIC codes (a four digit number) that best describe your company's products, services, or industn'al activity. Example: 7384 photofinishing lab 7218 Indu.rtrial launderers Fk~st: 8011 Offices & clinics of Second: 7384 Photofinishing lab Medical doctors V. PRIOR PERM1T STATUS: YES NO I-! l'Xl I-I [] 2. ['q[] 3. D 4. Check yes or no to each question: Did you file a PBR Notice of Intent to Operate (DTSC Form 8462) in 1992 for this location.'? Do you now have or have you ever held a state or federal haTardous waste facility full'permit or interim status for any of these treatment units? ., :, .., Do you now have or have you ever held a state or federal full permit or interim status for any other . ha~'ardous waste activities at this location? '.' Have you ever held a variance issued by the Department of Toxic Substances Control for the treatment you are now notifying for at this location? Has this location ever been inspected by the state or any local agency as a hazardous waste generator? Vie PRIOR ENFORCEMENT HiSTORY: NO Not required from generatom only notifying as conditionally ~.mnpt or as a Within the last three years, has this facility been the subject of any convictions, judgments, settlements, or final orders resulting from an action by any local, state, or federal environmental, hazardous waste, or public health enforcement agency? (For the purposes of this form, a notice of violation does not constitute an order and need not be reported unless it was not corrected and became a final order.) If you answered Yes, check this box and attach a listing of convictions, judgments, settlements, or orders and a copy of the cover sheet from each document. (See the Instructions for more information) ATTACFIMENTS: Attadmum~ are not requir~for Commercial Laan~ryf~. 1. A plot plan/map detailing the location(s) of the covered unit(s) in relation to the facility boundaries. 2. A unit specific notification form for each unit to be covered at this location. DT$C 1772 (7/94) Page 2 . EPA ID NUMBER Page 3 of 7 CERTIFICATIONS: This form must be signed by an authorized corporate o. lTicer or any other person in the company who has operational control and peoeormx decision-malting functions that govern operation of the facility (per Title 22, California Code of Regulations (CCR) Section 66270.11). All three copie~ must haw original signaturar. Waste Minimizatign I certify that I have a program ia place to reduce the volume, quantity, and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environmeat. Tiered Permittine Certification I certify that the unit or units described ia these documents me~t the eligibility and operating requirements of state statutes and regulations for the indicated permitting tier, including generator and secondary containment requirements. I understand that if any of the units operate under Permit by Rule or Conditional Authorization, I will also be required to provide required financial assurances by January 1, 1995, and conduct a Phase I environmental assessment by January I, 1995. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision ia accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those directly responsible for gathering the information, the information is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are substantial penalties for submitting false information, includiag the possibility of fmcs and imprisonment for knowing violations. Jerry Sturz Name (Print or Type) Signature Date Signed Adm~ n~ A~.r~.~ v~ D~ Title OPERATING REQUIREMENTS: Please note that generators treating hazardous waste onsite are required to comply with a number of operating requirements which differ depending on the tier(s). These operating requirements are set forth in the statutes and regulations, some of which are referenced in the 77er-Speci. fic Fact Sheets available from the Department '$ regional and headquarters o. OCices. SUBMISSION PROCEDURES: You must submit two copies of this completed notification by certified mail, return receipt requested, to: Department of Toxic Substances Control Onsite Hazardous Waste Treatment Unit ,400 P Street, 4th Floor (walk in only) P.O. Box 806 Sacramento, CA 95812-0806. You must also submit ong copy of the notification and attacl~nents to the local regulatory agency in your jurizdiction as listed in Appendix 2 of the instruction materials. You must also retain a copy as part of your operating record. All three forms must have original signatures, not photocopies. DTSC I772 (7/94) Page 3 EPA ID NUMBER CONDITIONALLY EXEMPT - SPECIFIED WASTESTREAMS UNIT SPECLClC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) Page4of7 The Tier-Specific Fact Sheets contain a summary of the operating requirements for this category. PI~ review those ~luirements c~refully before completing or submitting this notification package. UNIT NAlVIE Si lv~r R~ml ~ m~r UNIT ID NUMBER 1 NUMBER OF TREATMENT DEVICES: 1 Tank(s) 1 Container(s)/Container Treatment Area(s) Each unit must be clearly identified and labeled on the plot plan attached to Form 1772. Assign your own unique number to each unit. The number can be sequential (1, 2, 3) or using any system you choose. Enter the estimated monthly total volume of hazardoas waste treated by this unit. This should be the maximum or highest amount treated in'any month. Indicate in the narrative (Section II} if your operation.v have seasonal variations. L W~ AND TREATMENT PROCF_3SES: Estimated Monthly Total Volume Treated: pounds and/or 29 gallons YES NO Is the waste treated in this unit radioactive? [l_] [~ Is the waste treated in this unit a bio-hazard/infectious/medical waste? El The following are the eligible wastestreams and treatment process~. Please check all applicable boxes: 1. Trea~ resim mixed in accordance with the manufacturer's instructions. F1 Treat containers of 110 gallons or less capacity that contained hazardous waste by rinsing or physical processes, such as crushing, shredding, grinding, or puncturing. El e Drying special wastes, as classified by the deparhnent pursuant to Title 22, CCR, Section 66261.124, by pressing or by passive or heat-aided evaporation to remove water. E] Magnetic separation or screening to remove ~mponents from special waste, as classified by the depm:ai~ent pursuant to Title 22, CCR, Section 66261.124. El 5. Neutralize acidic or alkaline (base) wastes from the regeneration of ion exchange media used to demineralize water. (This waste cannot contain more than 10 percent acid or base by weight to be eligible for conditional exemption.) F'l 6. Neutralize acidic or alkaline (base) wastes from the food processing industry. Recovery of silver from photofinishing. The volume limit for conditional exemption is 500 gallons per generator (at the same location) in any calendar month. DTSC 1772B (7/94) Page 10 EPA ID NUMBER CAL 000C CONDITIONALLY EXEMlq' - SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (.pursuant to Health and Safety Code Section 25201.5(c)) PageSor~__.7 8. Gravity separation of the following, including the use of flocculants and demulsifiera if a. The settling of solids from the waste where the re.suiting aqueous/liquid stream is not baTardous. b. The separation of oil/water mixtures and separation sludges, if the average oil recovered per month is less than 25 barrels (42 gallons per barrel). 9. Neutralizing acidic or alkaline (base) material by a state certified laboratory or a laboratory operated by an educational institution. (To be eligible for conditional exemption, this waste cannot contain more than 10 percent acid or base by weight.) 10. Hazardous waste treatment is carried out in quality control or quality assurance laboratory at a facility that is not an offslte hazardous waste facility. 11. A wastestream and treatment technology combination certified by the Department purauant to Section 25200.15 of the Health and Safety Code. NARRATIVE DESCRIPTIONS: Provide a brief description of the specific waste treated and the treatment process used. 1. SPECIFIC WASTE TYPES TREATED: Photo Fix~_r ~onf. ainin9 ~i lv~r 2. TREATMENT PROCESS(ES) USED: Electrolytic and Metallic Replac~m~_nt. RESIDUAL MANAGENfENT: Check Yes or No to each question ax it applies to all residuals from this treatment unit. NO I~l 1. Do you discharge non-hazardous aqueous waste to a publicly owned treatment works (POTW)/sewer? 2. Do you discharge non-hazardous aqueous waste under aa NPDES permit? 3. Do you have your residual hazardous waste hauled offsite by a registered hazardous waste hauler'?. If you do, where is the waste seat'?. Check all thru apply. [] a. Offsite recycling I'-! b. Thermal treatment [--'! c. Disposal to land l-'! d. Further treatment ['X] 4. Do you diSPOse of non-hazardous solid waste residues at an offsite location? 5. Other method of disposal. Specify: DTSC 1772B (7/94) Page 11 EPA ID NUMBER CAL 00~7802 CONDITIONALLY EXEMIrr - SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) Pag¢6 of 7 BASIS FOR NOT NEEDING A FEDERAL PERAflT: In order to demonstrate eligibility for one of the onsite treatment tiers, facilities are required to provide the basis for determining that a hazardous waste permit is not required under the federal Resource Conservation and Recovery Act (RCRA) and the federal regulations adopted under RCRA (77tie 40, Code of Federal Regulations (CFR)). Choose the reason(s) that describe the operation of your onsite treatment units: The haTardous waste being treated is not a baTardous waste trader federal law although it is regulated as a bu~'-rdous waste under California state law. r"] 2. The waste is treated in wastcwater treatment units (tanks), as defined in 40 CFR Part 260.10, and discharged to a publicly owned treatment works (POTW)/scwering agency or under an NPDES permit. 40 CFR 264. l(g)(6) tad 40 CFR 270.2. The waste is treated in elementary neutralization units, as defined in 40 CFR Part 260.10, and discharged to a POTW/sewering agency or under an NPDES permit. 40 CFR 264.1(g)(6) and 40 CFR 270.2. l'-! 4. The waste is treated in a totally enclosed treatment facility as defined in 40 CFR Part 260.10; 40 CFR 264. l(g)(5). The company gencrate~ no more than 100 kg (approximately 27 gallons) of hazardous waste in a calendar month and is eligible as a federal conditionally exempt small quantity generator. 40 CFR 260.10 and 40 CFR 261.5. l-'] 6. The waste is treated ia an accumulation tank or container within 90 days for over 1000 kg/month generator~ and 180 or 270 days for generators of 100 to I000 kg/month. 40 CFR 262.34, 40 CFR 270. l(e)(2)(i), and the Preamble to the March 24, 1986 Federal Register. Recyclable materials are reclaimed to recover economically significant amounts of silver or other precious metals. 40 CFR 261.6(a)(2)(iv), 40 CFR 264. l(g)(2), and 40 CFR 266.70. r-I 8. Empty container rinsing and/or treatment. 40 CFR 261.7. [-'] 9. Other:. Specify: V. TRAJqSPORTABLE TREATMENT UNIT: YES NO Check Yes or No. Please refer to the Instructions for more information. Is this unit a Transportable Treatment Unit? It' you answered yes, you must also complete and attach Form 1772E to this page. DTSC I772B (7~94) Page 12 EPA ID NTI4BER ~CAL000077802 Page. 7 of 7 Hwy 178 PLOT PLAN Physicians Plaza Medical Imaging Center c/o Kaiser Permanente East Hills 3701 Mall View Rd. (akersfield, CA 93306 805) 334-2982 (facility) (805) 395-0155 (contact person) LOBBY Processor(A) I~ Silver Reclaimer(B) A · ~ - , _ Silyer ~ ~ [ · Canisters[C) Drain Mall View Road STATE OF CALIFORNIA--CAUFORNIA ENViRONME~kT~L PROTECTION AGENCY '~' DEPARTMENT OF TOXIC b~uSTANCES CONTROL. 400 P STREET, 4TH FLOOR ~ P.O. BOX 806 ~' SACRAMENTO, CA 95812-0806 (916) 323-5871 PETE WILSON, Governor 01/17/95 EPA ID: CAL000077802 PHYSICIANS PLAZA MED IMAGING CI'R JOYCE AYERS 4000 PHYSICIANS BL #101 -BAKERSFII~LD, CA 93301 3700 MALL VIEW RD BAKERSFIELD, CA 93306 Authorization Date: 01/17/95 Dear Conditionally Authorized and/or Conditionally Exempt Facility: ACKNOWLEDGEMENT OF UNITS OPERATING UNDER CONDITIONAL AUTHORIZATION AND/OR CONDITIONAL EXEMPTION The Dep~t of Toxic Substances Control (DTSC) has received your facility specific notification (form DTSC 1772) and forms for Conditional Authorization and/or Conditional Exemption for Specified Waste. streams (form DTSC 1772B and/or 1772C). Your notifications am administndively complete, but have not been reviewed for technical adequacy. A technical review of your notifications will be conducted when an inspaction is performed. At any time, you may be inspected and will be subject 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 sections25200.3 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 annual fees calculated on a calendar year basis for each year you operate and have not notified DTSC that the units have been closed. You must notify the DTSC 60 days before first treating hn-nrdous 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 le~er to the above address explaining the changes, attach only the pages of your aotification 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 Conditiomd 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 misrepresen~on 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: CAL000077802 If you have shy questions regarding this letter, or have questions on operating requirements for your facility, please co~tact the nearest DTSC regional office, or this office st the letterhead address or phone number. Enclosure ASTRID JOHNSON DTSC REGION 1 STATE REGULATORY PROGRAM 1515 TOLLHOUSE CLOVIS, CA '93611 Michael S. Homer, Chief Onsite HnTnrdous Waste Treatment Unit Permit Strenmllnlng Branch Hazardous Waste Management Program STEVE MCCALLEY KERN COUNTY ENVIRON. HEALTH SERVICES DEPT 2700 M STREET, SUITE 300 BAICl~RSFIELD, CA 93301 Pag~ 3 ~NCLOb-~IR~ 1 UNDER CONDITIONAL AUTHORIZATION: EPA ID: CAL000077802 UNDER CONDITIONAL EXEMFI'ION: 1