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Home My WebLink AboutBUSINESS PLAN 2/16/2007- _-~`f...- - -~ _ ~I ~I ~; SAN DiMAS ORTHODONTIC CENTER ~~1 ~J a - ~` ~. SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 Manager SUZANNE CALVILLO Location: 3807 SAN DIMAS ST C City BAKERSFIELD BusPhone: (661) 634-9344 Map 103 CommHaz Minimal Grid: 19B FacUnits: 1 AOV: CommCode: BFD STA 04 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title su / ~~~~-z a u~~R Emer envy Contact / Title , cerl~-~ / 1~~' ~~2~J4'l~~j'' ~~'~~I~ ~ Business Phone: (661) 634-9344x ~ Business hone: (~(p/ ) ;~`~~-~i ~x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact SUZANNE CALVILLO Phone: (661) 634-9344x MailAddr: 3807 SAN DIMAS ST C State: CA City BAKERSFIELD Zip 93301 Owner ~j~,~~ ~~ Phone : ( 6 61) 6 3 4- 9 3 4 4 x Address 3807 SAN DI S ST C State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~N~~~ ~~~ ~ ~ ~a~ O~:ccd on my 'snquiry of those individuals respr,.n^'I";e it7r obta'ning the information, I certify ' t~ln;. sEr s;enaity of law that I have personally exec??inert and am familiar with the information s.~brriztert and believe the information is true , accurU~e, and complete. ~ Z ~~ "~ - Dat -1- 02/06/2007 ., :,~ F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 5.00 GAL Min -2- 02/06/2007 -3- 02/06/2007 F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit' Map: Grid: DARKROOM CAS# STATE TYPE PRESSURE TEMPERATURE ~ CONTAINER TYPE Liquid TWaste Ambient ~ Ambient I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL IIHGL-itCLVUa 1.,V1~lYV1VI;1V1.7 $Wt. RS CAS# Silver No 7440224 r1HGEitCL H A.~I;JJ1~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/06/2007 F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ ~ Notif./Evacuation/Medical OveralloSite ~ r1yc11~1. 1VV 1.1111:c11.1V11 • i ~.. ~Lll~J1 Vy CC 1VV 111 ~ P~VCLt.: UGLL1Vll • i ~.. t UJ.Jl lt. 1VV l..Ll ~ i'~VQI:UQl.1 Vll P~LIlC 1.yC11C: ~/ 1.1CC.11 C:d1 Y1d11 -5- 02/06/2007 F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 1CG 1C0.~C t.V111.0.11111LC11llL - ~.ica,ll VN ~X'l-~ ~ ~-e~-~ ~~G~ V~llcl_ lcc~vul_~:c r1l.l..lval.1V11 -6- 02/06/2007 _ :_ . .. F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ JYCC:1d1 ridGd.LU~ V1.1111.y .711111.-V11~ , E-' \ ~ fir' C S1~-~,v~~-'~D~s ° ~ ~n 1~~c.~ 0-~~-i csZ ~v,~a.roJ~ ~~ o ~.e;~- , WU~C~~-~ ~~ V~;a- - C7 t"T ~(~ ~ C~~ 1 1r~ ~U-C'J~ ~~ ~~-~,\ G~ 1,1'l Cam` = Fire Protec./Avail. Water `/~ ,_ _ ~..~uiiuiiiy Vt.liUt/0.111.y LcVGl -7- 02/06/2007 ~ ~~ _ !. F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 Fast Format ~ Training Overall Site Employee Training 9 rdye Held for Future Use nclu iui ru~uiC u~C -8- 02/06/2007 BARERSFIELD FIRE DEPT ~.~- ~~ Prevention Services UI~IFI~D PROGRAM INSPECT10~1 CHECKLIST ~? ~~~~ 90o Trtixtun Ave., Butte 210 "'CTIONM 1~: ` BLIS1,;11@SS~ :.... .:rt . W,,, . - , ,,,.; '.:. , ~ R>rr Bakersfield. CA 93301 SE~ Plan and Inventory Program ~ Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE NSPECTION TIME Sp~~ ~+,.,,~~ o~-rl-~d~®N Iles cE~-~~~ 3 ~- 07 ADDRESS HONE NO. O OF EMPLOYEfiS FACILITY CONTACT ~ ~ USINESS ID NUMBER 15-021- a3 ~c n.~ ~,~, rZ~: Section 1: Business Plan and Inventory Program ^ ROUTINE ~ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION 1 1 C V (c=compliance) OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND BUSItI@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY EN r ' 9 ^ VERIFICATION OF HAZ MAT TRAINING 407 ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON ITE? YES ^ NO EXPLAIN: W ~ ~'~"Z ~I K E~ _ QUESTIONS REGARDING THIS INSPECTION4 PLEASE CALL US AT (881) 328-3979 Inspector (Please Print) Fire Prevention / t" In ! Shift of Site/Station # Rosins PaAy (Please Print) White -Prevention Serviees Yellow -Station Copy Pink -Business Copy FD20~9 (Rev. 02!05) :r--'- `~ ~` `rc~'`~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~ OFFICE OF ENVIRONMENTAL SERVICES b .y UNIFIED PROGRAM INSPECTION CHECKLIST ~k•E`~gti~~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME SA ~ ~ ~ was (~e-r +~ o,x~ N-T ~ c s CF r-r eCt INSPECTION DATE 3 / ~ / U 7 Section 4: Hazardous Waste Generator Program EPA ID # L~x~'~~ ~ ^ Routine ~6 Combined ^ Joint Agency ^Multl-Agency ^ Complaint ^ Re-inspection OPERATION C V .COMMENTS Hazardous waste determination has been made EPA ID Number ~` }~ E M ~ j Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided e Conducts daily inspection of tanks Used oil-not contaminated with other hazardous waste ~ Proper management of lead acid batteries including labels Proper management of used oil filters IJ ~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years lr' ~ 1 ><-6 G~~G., Z 6 Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal ~=~ompiiance v=v~o~auon Inspector: ~ ~E.¢ ,~ t ~. ~_ Office of Environmental Services (661) 32 -3979 B iness Site Res sible Party White -Env. Svcs. Pink -Business Copy .~: r ~. SAN DIMAS ORTHODONTICS CENTER Manager ARLENE AGUIRRE Location: 3807 SAN DIMAS ST C City BAKERSFIELD SiteID: 015-021-002364 BusPYione: (661) 634-9344 Map 103 CommHaz Minimal Grid: 19B FacUnits: 1 AOV: CommCode: BFD STA 04 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title ARLENE AGUIRRE / OFFICE MANAGER / Business Phone: (661) 634-9344x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact :: ~ir1P~~ ~-~Gl.,~ B"~~ Phone: (661) 634-9344x MailAddr: 3807 SAN DIMAS ST C State: CA City BAKERSFIELD Zip 93301 Owner INTERDENT Phone: (661) 634-9344x Address 3807 SAN DIMAS ST C State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN Based on my inquiry of those individuals respon:,i;,~e for oc~taining the informa~ti ! or~, certify under penalty cF ia~~,f that I have personally e xamined and am farr,iiiar va,th the information submitted and beliSVE th i e nformation is true, accurate, and complete. - .~ ~ ~~ Ci n g a Da -1- 07/16/2007 F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax~nit~CPl WASTE FIXER R L 5.00 GAL Minl -2- 07/16/2007 ` r F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification . ,~ 1S lll~JlVyCC 1VV 1.11. / P~VQtr UCLL1V11 _i_ t _ r /~ rW.J11V 1VV 1.11 . ~ iJVGLt.U0.1.1 V11 Emergency Medical Plan -3- 07/16/2007 ,. F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention Release Containment 02/22/2007 STERICYCLE DOES PICK-UP Clean Up 02/22/2007 DONE BY STERICYCLE V1.11CL tCC.b"VULC:C LiGL1Vdl.1Vi1 -4- 07/16/2007 J T F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~CC:1c11 rid'GdrU~ Utility Shut-Offs 02/22/2007 ELECTRIC - BACK OFFICE STORAGE CLOSET WATER - OUTSIDE BACK OF BLDG Fire Protec./Avail. Water YES 02/22/2007 .~ „ L7U11lA Illy V1: 1.. U~J GLllI. ~/ LCVC1 -5- 07/16/2007 u _ ,- F SAN DIMAS ORTHODONTICS CENTER SiteID: 015-021-002364 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/22/2007 ~ DONE IN OFFICE rayc a nclu Lui ruLUte use nciu tvi rul.ulC USe -6- 07/16/2007 Suzanne Ca~vfil~o Office Manager Ortho. dontlc Center (661) 634-9344 3807 San Dimas St., Ste. C (661) 634-0270 - Fax Bakersfield, CA 93301 F SAN DIMAS ORTHODONTI, Manager : Location: 3807 SAN DIMAS C City : BAKERSFIELD CommCode: BAKERSFIELD STATION 04 EPA Numb: SiteID 015-021-002364 BusPhone: (661) 634-9344 Map : 103 CommHaz : Grid: 19B FacUnits: 1 AOV: SIC Code:8021 Emergency Contact / Title SUZANNE CALVILLO / OFFICE MANAGER Business Phone: (661) 634-9344x 24-Hour Phone : ( ) _ x Pager Phone : ( ) - x Hazmat Hazards: Contact : SUZANNE CALVILLO MailAddr: 3807 SAN DIMAS C City : BAKERSFIELD Owner Emergency Contact Business Phone: 24-Hour Phone : Pager Phone : / Title / ) - X ) - X ) - X React Phone: (661) 634-9344x State: CA Zip : 93301 Address : 3807 SAN DIMAS C City : BAKERSFIELD Period : Phone: (661) 634-9344x State: CA Zip : 93301 Preparer: Certif,d: ParcelNo: Emergency Directives: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Do hsrsb¥ c~r~i~ ~hs~ ~ hays agsmsn~ p~an for ~y ~acil~. Date -1- 10/17/2003 CITY OF BAKERSFItELD FIRE DEPARTMENT UNIFIED PR~G~M INSPECTION CHECKLIST 1715 Chester Ave., 3~ Floor, ~akersfieid, CA 93301 FACILITY NAME ~ O,.~t~> ~Oo,af',c Ct:::~,ar_.a-INSPECTION DATE ~ ~C/OZ' Al)DRESS 5~OD ~ v,~ ~ PHONE NO. 6~-q~4~ FACILITY CONTACT 5°2~ ~tc~ BUSINESS ID NO. 15-210- ~ INSPECTION TIME NUMBER/o ~ -/~ - ~OF EMPLOYEES~ ~ ~ Section 1: Bus,ness Plan and Inven~o~ Program ~/ ~ Routine ~Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities ,~- Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on Explain: ~t-~ Yes I~ No Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy ' l~iness Site Responsible'Party Inspector: CITY OF BAKERSFIEL'D FIRE DEPARTMENT OFFICE OF: ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave.; 3rd Floor, Bakersfield, CA 93301 f'556 Section 1: [~ Routine ~-Combined [~ Joint Agency [~ Multi-Agency [,~ Complaint FACILITY NAME '~ 0,~tx~ C_a~r~t~c CC-,,~e.-INSPECTION DATE ADD. SS ~o~ (~ o.~s ~ PHONE NO. FACILITY CONTACT 5o2~ ~c~ BUSINESS IDNO. 15-210- ~SPECTION TIME · NUMBER OF EMPLOYEES~o Bus[ness Plan and lnVent°~ Program OPERAT~ ION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Re-inspection Any hazardous waste on site?: ~ Yes ,[~ No Explain: {,~k~%T~ ~ Ig.(.f~. ' ~ ': :. Questions regarding this inspection? Please call us ~t ('66~) 326-3979 White - Env. Svcs. Yellow - Station Copy' ' Ping - Business Copy B, dsiness Site ResPonsible'Part~ . Inspector: ~CITY OF BAKERSFIELD FIRE DEPARTMENT ~g~ ~ ~ OIFFICE OF ENVIRONMENTAL SERVICES ~,~,a .-~'~'~. '~ UNIFIED PROG~M INSPECTION CHEC~IST 1715 Chesler Ave., 3'a Floor, Bakersfield, CA 93301 FACILITY NAME ~ D,~ O~~nc ~~ ~SPECTION DATE ~ Section 4: Hazardous Waste Generator Program EPA ID # [] Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal C=Compliance V=Violation (~i~ ~/~~ Inspector: [~ t ~J ~ ~ Office of Environmental' Services (661) 326-3979 Busine~t/Site Responsible Party White - Env. Svcs. Pink - Business Copy