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i 1800 WESTWIND DR 301
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Hazardous
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~ Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous Waste On-Site Treatment
93301
1800
LOCATION
OCT 2 5 2001
Issue Date
Approved by:
Expiration Date:
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576
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CITY OF BAKERSFIEl.,D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd ¡·'Ioor, Bakersfield, CA 93301
fACILITY NAME \)J ß ~(¡Stí~V\Ç(^ (40
ADDRESS (CfJd:J 4)~A OY'" It ~ \
F ACILITY CONTACT C i· f:x,.rI-k H
INSPECTION TIME \1: 15
INSPECTION DATE \\ -11Jo ~
PHONE NO. ~1-á6~O/3;27-q'/4
BUSINESS ID NO. 15-210- I
NUMBER OF EMPLOYEES~ ¿)IS
SedioHD J:
Æoutine
Business Plan and Inventory Program
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERA nON c v COMMENTS
Appropriate pennit on hand /
Business plan contact information accurate I
, V
Visible address
Correct occupancy /
Verification of inventory materials J
Verification of quantities /
Verification of location J
Proper segregation of material I
Verification of MSDS availability 1/ I fJ e.;J -t-o h~"L ~a ¡l"bk "'~ -4hi$ 5 :¡<..,
Verification of Haz Mat training II
Verification of abatement supplies and procedures IJ
Emergency procedures adequate 1/
Containers properly labeled IJ
Housekeeping rl
Fire Protection 1.1 1/
Site Diagram Adequate & On Hand ',/
C=Compliance
V=Violation
Any lIBaz81l"dous waste on site?:
Explain:
ayes 6NO
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env, Svcs,
Yellow· Station Copy
Pink - Business Copy
Business Site Responsible Party
Inspector: t. - G-A'Q'UMfZ
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WEST BAKERSFIELD RADIOLOGY MED GP
SiteID:
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015-021-001923
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Manager :
Location: 2021 22ND 91' (~t..cX-'!>*u.HM #30 1
City BAKERSFIELD
CommCode: BAKERSFIELD STATION 01
EPA Numb:
BusPhone:
Map : 102
Grid: 25B
(805) 327-9617
CommHaz : Minimal
FacUnits: 1 AOV:
SIC Code:
DunnBrad:
Emergency Contact / Title E~ency Contact / Title
WE CHRISTIANSEN MD~ OWNER (J ~,,~no.nSoU\ Ie-FC> /
Business Phone: ( ) 327-9617x Business Phone: ((,(,\ ) 'ßd.ì - C(eø'lx
24-Hour Phone : (CW\5~~-~~ 24-Hour Phone : (t:t~\).&t,-..s ~ CIIox
Pager Phone : ( f.lfPi> - x Pager Phone : ( "t, I ) {''ð(,p - 'ì ~31x
Hazmat Hazards: React
Contact : Phone: (805) 327-9617x
MailAddr: 2021 22ND ST State: CA
City : BAKERSFIELD Zip : 93301
Owner WB CHRISTIANSEN MD Phone: (805) 327-9617x
Address : 2021 22ND ST State: CA
City : BAKERSFIELD Zip : 93301
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No .. '.
Emergency Directives: ~ ~e..p I( . +0 Dð\\c~
~+ l--:;)-O \ tit
One Unified List ì
All Materials at Site ì
F Hazmat Inventory
f== Alphabetical Order
Hazmat Common Name...
SpecHaz EPA Hazards
MCP
WASTE FIXER ¡JSIf)ç, ')(-(?AC( ~ R
~. /vI.141e(T (Ly~ fi,vJUCJl.Do hsrsby certifv ~ha~ ~ have
111>3 or pnnt nam~) JI
reviewed the attached hazardous materials manage-
0..ts,f-I8cM¿'u({,c.-/d ~_ Grv"'-p .
ment plan 10r ~. Ifð (1M{R0cL. 0 /c~nd that it alonn with
(Name of BuslnGss) ~
any corrections constitute a complete and correct man-
agement plan for my facility.
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08/16/2001
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f= Notif./Evacuation/Medical
[Agency Notification
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r=== Employee Notif./Evacuation
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SiteID: 015-021-001923 ì
Fas t Forma t ì
Overall Site ì
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Public Notif./Evacuation
Emergency Medical Plan
-2-
08/16/2001
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f= Mitigation/Prevent/Abatemt
[Release Prevention
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SiteID: 015-021-001923 ì
Fast Format ì
Overall Site ì
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Release Containment
sc.~~~ CeNJrð< "j~ VfJ'D(.<L ~~. ç:¡ ~
Clean Up
SIGMA }'\o'i~I£AL 1 ""l./.L&,.v(ý-
Other Resource Activation
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08/16/2001
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F WEST BAKERSFIELD RADIOLOGY MED GP
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f= Site Emergency Factors
¡== Special Hazards
Utility Shut-Offs
A) GAS - ~~o(;. ~S~ G--..rO ~ \h.,o,,-
B) ELECTRICAL - (j.,K'S'-.ö¿ S &--so òÇ. (3{..~
C) WATER - 6Þù'ï?, I~G t-<.J &v'O a-C ß(..Q:7-
D) SPECIAL -
E) LOCK BOX -
SiteID: 015-021-001923 ì
Fast Format ì
Overall Site ì
01/14/1999
Fire Protec./Avail. Water
01/14/1999
PRIVATE FIRE PROTECTION -
NEAREST FIRE HYDRANT - övT'>1~'G C cvo oC BLOG
Building Occupancy Level
-4-
08/16/2001
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F WEST BAKERSFIELD RADIOLOGY MED GP
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F Training
Employee Training
SiteID: 015-021-001923 ì
Fast Format ì
Overall Site ì
01/14/1999
HOW MANY EMPLOYEES AT THIS FACILITY??????????
DO YOU HAVE YOUR MSDS SHEETS ON FILE????????
GIVE A BRIEF SUMMARY OF YOUR TRAINING PROGRAM:
Page 2
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Held for Future Use
Held for Future Use
-5-
08/16/2001
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CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIR.ONMENT AL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME{.JC.-s<f r¡AK£R..sç:;c:.~ MÇ),~
INSPECTION DATE
( 0 þ7-
Section 4:
Hazardous Waste Generator Program
EP A ID #
~Routine
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS
Hazardous waste determination has been made
EP A ID Number (Phone: 916-324-1781 to obtain EP A 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 / ç>L.(-AoSE' ~IDG tl c.J II
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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
~
-
.. ..
us mess Site ResponsIble Party
Inspector:
Office of Environmental Services (661) 326-3979
White - Env, Svcs,
W rf\Jf;S
Pink - Business Copy