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Home My WebLink AboutBUSINESS PLAN SILLECT CARE ANIMAL HIIÞITAL L SiteID, ~:48 , .,. i ¡ Manager Location: 3920 N SILLECT AVE City BAKERSFIELD CommCode: COUNTY STATION 66 EPA Numb: 1.\)~~ ~ \.~ ~ BusPhone: Map : 102 Grid: 24A (661) 326-7400 CommHaz : FacUnits: 1 AOV: SIC Code:0742 DunnBrad: Emergency Contact N.D. ZACHERY ausiness Phone: '24 - Hour Phone : Pager Phone / Title / D.V.M. (661) 326-7400x (661) 871-7981x (661) 333-0166xCELL Emergency Contact ANN GARCIA Business Phone: 24-Hour Phone Pager Phone / Title / OFFICE ASSIST (661) 326 -7400x (661) 071 7981x3lolp, ~ () x Period Preparer: Certif'd: ParcelNo: to Fire ImmHlth DelHlth Phone: (661) 326-7400x State: CA Zip 93308 Phone: (661) 326-7400x . State: CA Zip 93306 TotalASTs: = Gal TotalUSTs: = Gal RSs: No .-, Hazmat Hazards: Contact: N.D. ZACHERY, D.V.M. MailAddr: 3920 N SILLECT AVE City BAKERSFIELD Owner Address City N.D. ZACHERY, D.V.M. 14505 TAHOE CANYON RD BAKERSFIELD Emergency Directives: b, ¡J/~DO hereby certify that I have me) reviewedLoe att~çhed hazardous materials manage- SiÍ/td. ~ . ment plan for A/¡/;m! ' 'Waf and that it along with (Name of Bu sa) any corrections constitute a complete and correct man- agement plan for my facility. 1/~~¥1It 11- IlrfJ 3 Date ~ ' /7/J)QôÎ -1- 10/21/2003 , . CITY OF BAKERS~LD ~.E OF ENVIRONMEN~ S_VICES 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER I OPERATOR IDENTIFICATION FACILITY INFORMATION ¿l/S: 62/ -ð023~;¡> 01Y).. 6-k...~ ¿,. t,. I. FACILITY IDENTIFICATION Page _ Of _ i FACILl1Y ID # I' i ¡ ¡Ii I ! 1 Year Beginning _, !: ' I ¡ I I I 6? CJO;;J. : BUSINES,S NAME (Same as FACILl1Y NAME or DBA- Doing Business As) ï:<J .--6L ' . a J -!-fospi-tt I SITE ADDRESS , -\3 q¿;;;. 0 N,,<8II/~£j-Av~ É . CITY~~/W 100 : Year Ending 101 3 : BUSIN@1 p~£~--------'or ; (p~~ (p - '1 'i.o..1;L. 103 104 : CA ¡ZIP I ! 106 q :3t5 l) '8 SIC CODE (4 Digit #) 0 71};}, 105 107 5 108 , 109 I OPERATOR PHONE . '_ . "~ t ~ v«" .,~. I ','" '...' "", . . ",- : _'.' ' . .' '. 0' " ,,:. , '.. ?,':"." '~(;::>::>.;',.<Y.~.':f-';~:;<::.·/·,::·~Xè.'.::f.·,,/::~..;"O,';:.:,,;>'. ..., .~?~:~<::','\"':':.v"'t0('>::(::>{·,:' ~""i':;; ,11,' 0, WN,E~.IN. FOR".M,ATION. . .,.,.,' " ·,,·fc',.::;;';.. . ',.> , . . '~.< ,.: ! -"\:~~~ :;~--'>;-~,>:::::,:r'~-, - - h -'_ : OWNER NAME N.D. ~t2h.erÝJ O. V,N, 111 ¡ OWNERPHONEldp/í3,;ìfL,--7J./fJð ; OWNER MAILING : ADDRESS I 112 I BUSINESS PHONE ! . ~~-HOUR PHONE (g {p I - "3 '1/ -7 q "?'(./ i p~m: '~f.Q/-t:.'3{3r~ -01 (p(p , , ," ,,_..'~ .' , ,: , ;--·'·.~':,:...'.::f.",'.,,;,.,:,':_,;.'..~.',.:.'.'..,'..:.'.:. ,.;,.,.' ..'" : ,<:_,';.~_)~~:~:~~p:.-.~:~:.~:.:.:' ,. '^".. _ ' ,f"\ r.},v. 113 116 , ",1 118 119 123 NAME 129 125 TITLE 130 126 131 127 24-HOUR PHONE 128 I PAGER # ,!:v·,ç~.~ltlf!C~-':ION\ '~;~i~"t{ ',~ :i:;;" ". 132 133 , i Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined l and am familiar with the information submitted in this inventory and believe the information is true. accurate, and complete. I SIGNAW OF WNE E OR ) II! DATE 134 NAME OF DOCUMENT PREPARER I 'llL l ' , VI- /!-jtJ-ul..- I INAæD,OWNE:OP TOR ;"'tv /{, '" TIT'¿9 ';~RATOR 135 137 \ UPCF (7/99) S:\CUPAFORMS\OES2730.TV4.wpd DNEW DADO ¡ o DELETE HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION - .. CITY OF BAKEIWiIE~ ~ICE OF ENVIRONMEfW'ALWRVICES 1715 Chester Ave., CA 93301 (661) 326-3979 o REVISE 200 (one form per material per bUilding or area) Page of ----.-.-.-.--. ----------------------.-..--------- " ,/ ~ I. FACILITY INFORMATION -SUSINESSÑAME (Same as FACILITY NAME or DBA, Doing Business As) QiJ/e£/f- ~l....4111'n--td / Ho.5plb I CHEMICAL LOCATION r ( C' r: 0 .,.- "--../ tu7. -FACILlTYï¡r# '" I' 1 MAP#(optional) D li!Þ. 201! CHEMICAL LOCATION Lrf D, t()ørn . CONFIDENTIAL (EPCRA) I 203! GRID # (optional) D Yes~o 202 204 ~---'- II. CHEMICALlNFORMATION 205 TRADE SECRET Dyes ~NO 206 If Subject to EPCRA, refet to instructions CHEMICAL NAME o >('(:jt?h COMMON NAME 0 It ,-- )<1 Y3~ Jì CAS # , 777;;;). -1-}4- 7 FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 207 EHS' D Yes )it No 208 209 ·(f EHS is'Yes,' al1 amounts below must be in Ib.. 210 212 CURIES ---~- TYPE P PURE D m MIXTURE PHYSICAL STATE D s SOLID D I LlaUID FED HAZARD CATEGORIES y;41 FIRE D 2 REACTIVE (Chad< all that apply) ANNUAL WASTE MAXIMUM AMOUNT D w WASTE 211 RADIOACTIVE Dyes No 213 214 LARGEST CONTAINER 215 D 5 CHRONIC HEALTH 216 STORAGE CONTAINER (Check all that apply) D a ABOVEGROUND TANK D b UNDERGROUND TANK Dc TANK INSIDE BUILDING D d STEEL DRUM o e PLASTIC/NONMETALLIC DRUM Of CAN o 9 CARBOY o h SILO o i FIBER DRUM OJ BAG o k BOX ~ CYLINDER D m GLASS BOTTLE D n PLASTIC BOTTLE D 0 TOTE BIN D p TANK WAGON 21g STATE WA TE CODE 220 N 221 DAYS ON SITE 222 ,3 &lfd/ft.ys/yr o Q RAIL CAR 223 D r OTHER STORAGE PRESSURE D aa ABOVE AMBIENT o ba BELOW AMBIENT 224 o aa ABOVE AMBIENT o ba BELOW AMBIENT o C CRYOGENIC 225 CAS # en 227 o Yes~No 228 229 '77: -44~~ 231 o Yes 0 No 232 233 235 o Yes 0 No 236 237 239 o Yes 0 No 240 241 243 245 2 234 ,. 238 242 DATE 246' 1f-¡fëJ l. UPCF (7/99) S:\CUPAFORMS\OES2731,TV4.wpd ~~ Lækld ~trd ~,.cj;O- w, ~ ~flJ"t</ Wð- £u"- . 8~r t:; fk ~tt\tc«1 cpr- ~ [kit- W~ &t ~J;- ~~ 6~ tÄlJf fG,o~ 9;¡'u ~lt . fc7cd . r?tWÚbI1 ~~~ ~ f200 W1 No(lth ~ 5L--rË ì)TI{iRÆ!1 SfLLECT CARE NJII't.ÆLþtOS]>L77tL 3Q;<'O Nt SI1.l-FCT" ÆlJ£· \~It ~ I})~ ~ . . ~.~( J-: VJ ~ VdtèAt ~ ,(gþ BIÇrrWJ 1\1. $Lì.LEa- /tV~. VæML t TD f), RS 1 ~ ~ fSiþ ;: fi'f'l ffvoVcy¡t- II V èCèIlf ~ . -¡ r.' . aLECT CARE ANIMAL HaIT. HAZARDOUS MATEmALS MANAGEMENT PLAN SECTION I: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Sillect Care Animal Hospital LOCATION: 3920 N. Sillect Ave. CITY: Bakersfield STATE: CA ZIP: 93308 PHONE: 661-326-7400 PRIMARY ACTIVITY: small animal veterinary hospital OWNER: N.D. Zachery, D.V.M. PHONE: 661-326-7400 MAILING ADDRESS: 3929 N. Sillect Ave., Bakersfield, CA 93308 EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. N.D. Zachery, D.V.M. Owner 661- 326- 7 400 661-333-0166 2. Ann Garcia Office Assistant 661-326-7400 661-871-7981 ;~ ; 'Õ ?J . &LECT CARE ANIMAL HAlT. HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION Ill: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: 1. Calibrate and service the anesthetic gas machine. 2. Check that the gas scavenging system for the anesthetic gas machine is connected and working properly. 3. When the anesthetic gas machine is not in use, make sure all control valves are off 4. Check the anesthetic gas machine and tubing for leaks. 5. Make sure that the soda-lime crystals, pertaining to the anesthetic gas machine, are changed per specs and properly logged. 6. Check the X-ray developer and fixer containers and hoses for leaks. 7. Check the chemical spill kit for adequate components and supplies. B. EMPLOYEE AND AGENCY NOTIFICATION: 1. In case of a hazardous material spill or emergency, call 9-1-1 and the Office of Emergency Services at 1-800-852-7550. 2. For non-emergency spill reporting, call Poison Control at 1-800-876- 4766, National Response Center (NRC) for toxic chemical and oil spills at 1-800-424-8802, or the City of Bakersfield OffICe of Environmental Services at 661-326-3979. C. ENVIRONMENTAL RESPONSE MANAGEMENT: 1. Ann Garcia (Office Assistant) or N.D. Zachery, D.V.M. (Owner) is responsible for notifying authorities and clean up companies, etc. and making sure these activities are carried out. 2- ... ; ,~ . aLECT CARE ANIMAL øIPIT. HAZARDOUS MATERIALS MANAGEMENT PLAN . D. EMERGENCY MEDICAL PLAN: 1. Employees are to report all medical emergencies to Ann Garcia or N.D. Zachery, D.V.M. 2. Call 9-1-1. 3. The nearest hospital is Mercy Hospital, 2215 Truxton Ave., Bakersfield, CA 93301,661-632-5000 or Bakersfield Memorial Hospital, 420 34th St., Bakersfield, CA 93301,661-327-4647. SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: 1. Ensure adequate labeling of all hazardous materials. 2. Maintain a list of the hazardous substances in the workplace. 3. Maintain a collection ofMSDS's in a place accessible and known to all employees (reception area, cabinet above computer) 4. Train employees about the materials, labels, MSDS emergency procedures and handling precautions. 5. Alert all employees in the hospital when they are at risk of exposure to chemicals used by their co-workers in the workplace. 6. Monitor the compressed gas cylinders: a. Make sure that the valves aren't damaged. b. Make sure that they are kept away fÌ"om heat, stairs, and flame. c. Make sure that they are isolated from combustible gas installations and combustible materials by adequate distance. d. Make sure that the contents are clearly identified, and that they are labeled whether empty or full. e. Make sure that they do not lie on their side without special racks to hold them in place, 3 " . r. '''~ . aLECT CARE ANIMAL HAlT. HAZARDOUS MATERIALS MANAGEMENT PLAN 7. Never use grease, cleaning solvents or other flammable materials on an oxygen valve, regulator or piping. 8. Nitrile gloves should be worn when decontaminating treatment rooms or when handling hazardous chemicals. 9. Masks in combination with eye protection devices (goggles or glasses) should be worn whenever splashes, spray, splatter, or inhalation of a hazardous chemical/material occurs. 10. Whenever handling the X-ray developer and fixer, an apron, nitrile gloves, and approved safety goggles should be worn, in addition to having an operating exhaust fan operating. B. RELEASE CONTAINMENT AND/OR MITIGATION: 1. Utilization of the chemical spill kit, located in the X-ray room, will assist in keeping a hazardous material incident as small or confined as possible. C. CLEAN-UP AND RECOVERY PROCEDURES: 1. In case of small spills in the hospital, the chemical spill kit will be utilized. 2. In case oflarger spills, the hazardous material will be contained in a regulated waste container or red bag labeled BIOHAZARD with the biohazard symbol or BIOHAZARDOUS WASTE. a. The label should be' fluorescent orange or orange-red. 3. The hazardous material (X-ray developer and fixer) will be transported via Jim Warren X-ray Solutions away fÌ'om our facility. UTILITY SHUT -OFFS (LOCATION OF SHUT -OFFS AT YOUR FACILITY) NATURAL GASIPROPANE: Located on the outside of the east wall of the building, between the East Exit and the Electrical Panel Room. t..! .' . r.. . aLECT CARE ANIMAL nIPIT. HAZARDOUS MATEIDALS MANAGEMENT PLAN ELECTRICAL: Located on the east wall of the building, inside the Electrical Panel Room, on the north wall of the room. WATER: Located outside the building, near the middle of the south wall. SPECIAL: N/ A LOCK BOX: NO PRIVATE FIRE PROTECTIONIW ATER AVAILABILITY A. PRIVATE FIRE PROTECTION: 1. Fire Extinguisher # 1 is located in the Pharmacy Room on the southwest wall adjacent to the Employee's Restroom. 2. Fire Extinguisher #2 is located in the Utility Room on the west wall between the Hot Water Heater and the door. 3. Call 9-1-1. B. W ATER AVAILABILITY (FIRE HYDRANT): 1. The closest fire hydrant to be used by the Fire Department in case of an emergency is located at the southern edge of the lot, near the curb, just west of the east driveway. SECTION ill: TRAINING NUMBER OF EMPLOYEES: 5 MATERIAL SAFETY DATA SHEETS ON FILE: The MSDS's are located in the reception area, in the cabinet above the computer on the west wall. BRIEF SUMMARY OF TRAINING PROGRAM: 1. Train employees in the proper handling of the hazardous materials used by the hospital. 2. Instruct employees on the basics of the Cal OSHA Hazard Communication Standard. .,;- ... I. . aLECT CARE ANIMAL HalT. HAZARDOUS MATERIALS MANAGEMENT PLAN 3. Train employees in the correct use of emergency response equipment and supplies available at the hospital. 4. Train employees in the prevention, minimizing, and clean up procedures that have been developed for the hospital. 5. Train the employees in the emergency evacuation plans, notification procedure and medical plan that have been developed for the hospital. 6. Train the employees in the procedure to coordinate with and assist the local emergency personnel that may respond to the hospital. 7. Instruct the employees on the chain of command for calling for assistance in the event of an accident involving hazardous materials. CERTIFICATION . 1, f\I, /) zp¡Ufi:!/)),f!v(L~ CERTIFY THAT THE ABOVE V INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIY. 20 CHAPTER 6.95 SEe. 2550 ET AL.) AND THAT INACCURATE INFROMATION CONSTITUTES PERJURY. I!// ~IJ;!!/ SIGNA tYtf/l1tl'- TITLE If~/f~(};( DATE · eSI// ól1 .- o Joint Agency ~(',~ ( I ~1^,,1>i- INSPECTION DATE 'S t 4-{Ó'- PHONE NO. ~~6-74oò BUSINESS ID NO. 15-210- ¡v6.AJ NUMBER OF EMPLOYEES > /Ó:L -d...tf- 4- (}?~;¿ o Complaint o?3fF t)\ ~f\~\ X\ 0~ CITY OF BAKERSFIEI..D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd (;'Ioor, Bakersfield, CA 9330) FACILITY NAME $1(...(6:.-\ C'~ ADDRESS s;2Þ ""', ~IL<'~T FACILITY CONTACT \)~. ? M,.w.<:"./LI./ INSPECTION TIME Section ): Business Plan and Inventory Program ~ç. o Routine FiiÍ Combined o Multi-Agency ORe-inspection OPERA TION C V COMMENTS Appropriate pennit on hand ~ r~- 1',- s~ Business plan contact infonnation accurate Visible address Correct occupancy Verification of inventory materials ðXYr.;;:...J Verification of quantities 241 c..ç xL Verification of location 1N<;\ 1)£ /vi ,NCJCL S\.,.-!'~'I /rr~..p /2æJ,"1 Proper segregation of material V erification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: I2Í-Yes 0 No Explain: ~,Ll. ,~ :.Nþ..<j"Œ; Ç',)t.c:!L Questions regarding this inspection? Please call us at (661) 326-3979 White - Env, Svcs. Yellow· Station Copy Pink - Business Copy .. 1/"" ^ ~ Inspector: LA..)'--- , ,,~ '¡ , , , " \: . I \/ ., '.'" . -' 65t¡/óI1 cXJ5 t¡ p' !,\ :\V ~\ ~ \ 1\ , ~i\ \) \ V" ~~ .! CITY OF BAKERSFIEl.,D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKI...IST 1715 Chester Ave., 3rd f·'loor, Bakersfield, CA 93301 .pð~(>,'1'~ I I ~ IM(>t... INSPECTION DATE '51 4 ! ð""L.- PHONE NO, '3"2.6; 740ò BUSINESS 10 NO. 15-210- tfV6vJ NUMBER OF EMPLOYEES >' 4 ~~ F ACILlTY NAME <; u_(6:-T ('~t: ADDRESS So, 22> o-J, <;'L(~'f' FACILITY CONTACT '\)~. ~fJ.Lù.(i!l..V INSPECTION TIME Section I: Business Plan and Inventory Program /óJ. -.:2L(- I ()?9'2. o Complaint ORe-inspection o Routine ~Combìned o Joint Agency o Multi-Agency ( '...,- OPERATION C V COMMENTS Appropriate pennit on hand Ne!:i.,..J r~-,..,...... '$~ Business plan contact infonnation accurate Visible address Correct occupancy Verification of inventory materials ð'l('(tiC~ Verification of quantities U!1 c.~ ~'2.- Verification of location PNs, l)é' {<II INcA.. S'cA~V I?fzC-P ~ Proper segregation of material Verification of MSDS availability Veritìcation of Haz Mat training 0 , Verification of abatement supplies and procedures, Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Handf C=Compliance V = Violation ... Any hazardous waste on site?: !Zi-Ves CJ No Explain: ¿,J,&..l.. Iå~ vJp.<>,\~ Ç,,"'éL Questions regarding this inspection? Please call us at (661»26-;491~ White - Env, Svcs. Yellow - Station Copy Pink - Business Copy Inspector: