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HomeMy WebLinkAboutBUSINESS PLAN ":( ~ a -:2 ~ 11. .. --. - ---- ----- ~ ~... C'ß ~ .~ ~ sm DIAGRAM BuIineu Name: Business Address: :$.I·~ :rj) #" 2-iPg . W E So í '\1\) ( IV I"':) P{\ \/z.. .....-"\ ¡ ....) primary entrance 5 --~ DENTAL ~ ~ ,2. EYE lobby CLINIC L EX~N & CAREU AUDIOLOGY public waiting staff aC11i les PHARMACY fi MANAGEMENT ·D MENTAL HEALTH BUILDING MANAGEME T. SERVICE & SUPPLY ~. ~~ ~~ ~:::r- c...,¡. jc f I. , '¥ ßv~.ddtV\·q spn\.\\(J¿;v-~ á e ~. Cf~' .~ a: $.' l!.. u.. o ~. ) ~' in t:l~ \!) ~ ~. i ~~ "rJ ~ '~... ~~ w ~ 1 .V'. ~ q. ==1 s ~ 1 ~ 1 ~ iI ~ I ü ,1§1 . ~ \.) $ .> ~ t ~~ -J~ ~ J::. ~~ ~.~ .~ ~~ ~~ ß~ c ~ ~ "£ 0/.. ~ $. --:r.. \( I \..){\ v£.. N I"':) It. U. o ~ ~' II') t:1~ \9 +; <' .2. CLINIC4L EX~NI & CAREU I i \ \ .~~ rJ ~ '~).. a~ - lTIl1 - Ft A-iM~ ~(J @ ,~"hx2 ñ-6 £:. · ÇIR.'L·~rd ut-'-..Ji les \ MANAGEMENT public waiting mary entrance EYE prl ....-"'\ ¡ ..j ~ DENTAL f ~ ,2.. ~ t.t. . i ~ () "'2 WI EN PHARMACY \¥ .e I I I \ ~. ~~ ~~ Q¡;;- ().~ ~O ~ T, BUILDING MANAGEME SERVICE & SUPPLY t ~ ,D MENTAL HEALTH æ . ~ .~;'t·~·~":1~"'.··:~·":~I')~~:'Þ~}'~:;';";:£,~,I:,:.,., :.,;;iJ"'. "{~~ ,; ': I.·~·~ .-" ';",'f. ""',:::" ' ··,;'II}"<..··,;~>::;',1"}" .~~ h:~p'" .'. ·e· F'iI.' ':: .' :' :' '~::' , ;,' ".: : - , :,; ': :' :~ __ ',: ,=,:;.:",L',,' " " ~.....,::,';'<',' '. . ";L ' '. . Mate[iilsm~~aid()hs::W~ste . Unified' 'Permit CONDITIONS;'6~:p~'~ü;ì+ON~E~ERSE SIDE Hazardous i It! Hazardous Materials Plan o Underground Storage of Hazardous Materials ': 0 Risk Management Program. o Hazardous Waste On-Site Treatment Permit 10 #:: 015-000-000268 VA OUTPATIENT CLINIC LOCATION: 1801 WES1WINO DR Approved by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Date Issue Expiration Date: Issued by: ~- -----_. ---~~- --- - - - - Per [JJ it to Operil.te Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE - This permit is issued for the following: tI,~ardous Materials Plan " "'l~~$ilround Storage of Hazardous Materials PERMIT ID# 015-021.000268 "'Ig,agement Program VA OUTPATIENT CLINIC Waste LOCATION 1801 - Approved by: es Jun~30._ 2000 Expiration Date: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rdFloor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805)326-0576 Issued by: - ~~.....- H l\'m1 P P~ MAP SITE DIAGRAM I )( I FACILITY DIAGRAM I , Business Name: ßA-~5¡::'I~LD Ût) Tt')~íluet- ~Í-I fI},-c -'DV'r1 Business Address: I ~ 0 \, 1AJ:£.Sf vv\ ~\ L") D\! For Office Use Only First In Station: Inspection Station: Area Map # of NORTH {} ': . F.H, ::a == m Z ~ - iD m z ." X Þ q¡¡ ::a ¡¡: Þ 0 -< tD cn= mr"" ::a C ~ :S Z oc> m == ,- !II Þ cnZ cÞ ." ~, "1-== -<m :i <!.o~ '^' i> e ~ss: (Ib o)C.~ 1 ec,t . 3: > z > C> m 3: m z ... lTIIl -Ft~~~f> ,~'k"'-42fl-6f . ç'R.1...:l-tyd eA-A.Ji £Leè:t~L -en 111- n I» - .... =-- ii" en II (,¡J, C ü1~ ... Þ r"" -f\J(tCß~~1I\ L{'C»vP) m -< m 'C c !! ñ' ~ I» - - :I co o £: z o or"" Þm [j] z g. a , fJ¡~i· GAS 'C .. 3 III .. '< ell :I - .. III :I n CD <: o v <, ,., <::. r 1=, ~ " '. , W Rí'i~· . . \';) 1\)\))' CITY OF BAKERSFlEtD FIRE DEPARTMENT ~Ç)~ OFFICE OF ENVIRONMENT At SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Hoor, Bakersfield, CA 9330J FACILITY NAME VA QI..<\\'A-í(~ LL.1.,JtL ADDRESS I~OI LofJ;.-ruJIJJb bit. FACILITY CONTACT "O(ltl . .ßtANl..M INSPECTION TIME . ¡)'3C !flU. INSPECTION DATE {(II?? ~3 PHONE NO. (fde)G.3~- fðl (¡,¡:t)3'1S"l{L{7Lf BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES 'It) Section 1: ¿Routine Business Plan and Inventory Program D Combined D Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS '../ .. Appropriate permit on hand ~A"~,.$r f'()\A).j~ (Y.'--·Œ~ Business plan contact information accurate 1/ I ¡ Visible address ~ Correct occupancy I Verification of inventory materials / Verification of quantities .¡ Verification of location ¡ Proper segregation of material .¡ Verification of MSDS availability .¡ Verification of Haz Mat training j Verification of abatement supplies and procedures I . , II Emergency procedures adequate I . Containers properly labeled ( Housekeeping iv (~ Fire Protection / ~ , Site Diagram Adequate & On Hand .¡j V C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes \{ãNo White· Env, Svcs. Yellow· Station Copy Pink - Business Copy o<~Ø7~ Bu~iness Site Responsible Party Inspector:~ \(jJ Questions regarding this inspection? Please call us at (661) 326-3919 · e - ø .' ,. VA OUTPATIENT CLINIC SiteID: 015-021-000268 Manager : Location: 1801 WESTWIND DR City BAKERSFIELD BusPhone: Map : 102 Grid: 26B (661) 652-1801 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 EPA Numb: SIC Code:8093 DunnBrad:95-652-1504 Emergency Contact / Title Emergency Contact / Title GAYLE DEBOOM / LEAD CLINICIAN SMOKI FRANCISCO / SITE MANAGER Business Phone: (661) 632-1801x Business Phone: (661) 632-1801x 24-Hour Phone : (661) 663-4456x 24-Hour Phone : (661) 822-8028x Pager Phone : (661) 634-8921x Pager Phone : (888) 209-0717x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact Phone: (661) , : 65\2 -1801x MailAddr: 1801 WESTWIND DR State: CA 3 City : BAKERSFIELD Zip : 93301 Owner DEPT OF VETERANS AFFAIRS, US GOVT Phone: (661) ~ 652-1801x Address : 16111 PLUMMER ST State: CA 3 City \'- : SEPULVEDA Zip : 91343 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: One Unified List 9 All Materials at Site 9 f= Hazmat Inventory ~ Alphabetical Order Hazmat Common Name. . . SpecHaz EPA Hazards DailyMax MCP NITROGEN OXYGEN F P IH F IH DH ~ G.W\ vt;¡ (~Ù U5~ Do hereby certify ~ha~ I havs , (Typa or print name) reviewed 1he attached hazardous materials manage- ment plan fori ftlcuç "UJf uft and tha~ it along with ('a 0 USlnG$II) any corrections constitute a complete and correct man- agement plan for my facility. G G 460.00 FT3 Min 2500.00 FT3 Low -1- 10/26/2001 e e F VA OUTPATIENT CLINIC ~ Inventory Item 0002 == COMMON NAME / CHEMICAL NAME NITROGEN SiteID: 015-021-000268 9 Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit NE DENTAL CLOSET Map: Grid: CAS# 7727-37-9 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE FIXED PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 460.00 FT3 Daily Average 460.00 FT3 HAZARDOUS COMPONENTS ~ CAS# I 7727379 I l~~~åoINitrOgen TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min HAZARD ASSESSMENTS ~ Inventory Item 0001 == COMMON NAME / CHEMICAL NAME OXYGEN Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit SW CORNER Map: Grid: CAS# 7782-44-7 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE FIXED PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 2500.00 FT3 Daily Average 2500.00 FT3 %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -2- 10/26/2001 e e SiteID: 015-021-000268 ì Fast Format ì Overall Site ì 01/18/2000 f VA OUTPATIENT CLINIC I f= Notif./Evacuation/Medical Agency Notification LEAD CLINICIAN AND SITE MANAGER ARE THE IMMEDIATE EMERGENCY CONTACTS FOR OUTSIDE AGENCIES. THEY INITIATE AN EMERGENCY CALL-BACK CASCADE PROCEDURE FOR ALL STAFF VIA TELEPHONE. ADDITIONAL NOTIFICATION OF THE DIRECTORS OFFICE AND EMERGENCY COORDINATOR AT THE VA MEDICAL CENTER, WEST LOS ANGELES OCCURS BY TELEPHONE. Employee Notif./Evacuation 01/18/2000 EMPLOYEES IN THE CLINIC ARE NOTIFIED OF A DISASTER OTHER THAN FIRE THROUGH THE OVERHEAD PAGE SYSTEM. FIRE ALARMS RING THROUGHOUT THE BLDG AND THE SECURITY DESK IS NOTIFIED BY IIFIRE WATCHII OF THE EXACT LOCATION. COMPLETE FACILITY EVACUATION PLANS ARE IN PLACE AND EMPLOYEES ARE TRAINED ON PROCEDURES FOR STAFF AND PATIENTS. Public Notif./Evacuation 01/18/2000 PATIENTS IN CLINIC ARE AMBULATORY (NOT AN ACUTE CARE OR EMERGENCY FACILITY) AND ARE EVACUATED BY STAFF PER DISASTER PLAN. Emergency Medical Plan 01/18/2000 THIS IS AN OUTPATIENT CLINIC WITH SUFFICIENT MEDICAL STAFF ON HAND TO PROVIDE EMERGENCY MEDICAL CARE IF NEEDED UNTIL AMBULANCES CAN TRANSPORT TO AN ACUTE CARE FACILITY. -3- 10/26/2001 e e SiteID: 015-021-000268 ì Fast Format ì Overall Site ì 01/18/2000 F VA OUTPATIENT CLINIC I p= Mitigation/Prevent/Abatemt Release Prevention EMPLOYEES ARE TRAINED IN THE SAFE HANDLING AND USE OF ALL NON-~EPORTABLE QUANTITIES OF HAZARDOUS CHEMICALS. CONTAINERS OF SUCH MATERIALS ARE LESS THAN A GALLON AND MINIMAL QUANTITIES ARE ON HAND. BULK STORAGE IS MAINTAINED AT VAMC SEPULVEDA WAREHOUSE. Release Containment 01/18/2000 SMALL NON-REPORTABLE QUANTITIES OF HAZARDOUS FLAMMABLE LIQUIDS ARE STORED IN APPROVED FLAMMABLE STORAGE CABINETS WITHIN THE SITE. SUCH CABINETS ARE DESIGNED TO CONTAIN A LEAK AND PREVENT RELEASE. THE COMPRESSED GAS OXYGEN CYLINDERS ARE LOCATED AT THE EXTERIOR OF THE BLDG AND ARE CHAINED IN PLACE. ADDITIONAL COMPRESSED GAS NITROGEN CYLINDERS ARE LOCATED IN AN ENGINEERING CLOSET NEAR DENTAL CLINIC AND ARE CHAINED IN PLACE TO PREVENT RELEASE. Clean Up 01/18/2000 ALL LABORATORY AREAS ARE REQUIRED TO HAVE CHEMICAL SPILL KITS CAPABLE OF HANDLING SPILLS OF 1 TO 2 LITERS OF LIQUID AND EMPLOYEES ARE TRAINED IN THE METHODS OF CLEANUP. NO REPORTABLE QUANTITIES OF HAZARDOUS MATERIALS ARE MAINTAINED AT BAKERSFIELD, EXCEPT FOR THE COMPRESSED GAS OXYGEN AND NITROGEN CYLINDERS. Other Resource Activation -4- 10/26/2001 e e SiteID: 015-021-000268 ì Fast Format 9 Overall Site ì I F VA OUTPATIENT CLINIC I f= Site Emergency Factors r== Special Hazards Utility Shut-Offs 01/18/2000 A) GAS - GAS METER ,AT SE CORNER OF BLDG B) ELECTRICAL - MECHANICAL/ELECTRICAL ROOM SW CORNER NEAR EMERGENCY GENERATOR C) WATER - WATER METER AT SE CORNER OF PROPERTY AT CURBSIDE D) SPECIAL - OXYGEN TANKS AND SHUT-OFF MANIFOLD SW CORNER OF BLDG EXTERIOR Fire Protec./Avail. Water 01/18/2000 PRIVATE FIRE PROTECTION - THE FACILITY IS FULLY SPRINKLERED AND CONNECTED TO A 24 HOUR FIRE ALARM MONITORING SERVICE (TEL-TEC), 18 ABC FIRE EXTINGUISHERS LOCATED THROUGHOUT, 4 SMOKE DETECTORS CONNECTED TO AUTOMATIC FIRE WINDOWS IN PHARMACY AND CLINICAL CARE AREAS. NO ONSITE RESPONSE TEAM. NEAREST FIRE HYDRANT - FOUR FIRE HYDRANTS LOCATED AT EACH CORNER OF PROPERTY PARKING. Building Occupancy Level -5- 10/26/2001 .. ',- -.. e e F VA OUTPATIENT CLINIC I F Training Employee Training SiteID: 015-021-000268 9 Fast Format 9 Overall Site 9 02/01/1993 WE HAVE 51 EMPLOYEES AT THIS FACILITY. YES WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY AND DISASTER TRAINING IS FOR EACH NEW EMPLOYEE AND ANNUALLY AS A REFRESHER. THIS TRAINING IS PERFORMED BY SAFETY SPECIALISTS AND INDUSTRIAL HYGIENISTS FROM THE SEPULVEDA VA MEDICAL CENTER. AS A FEDERAL FACILITY, ALL TRAINING IS IN ACCORDANCE WITH FEDERAL OSHA STANDARDS AND VA POLICY AND INCLUDE FIRE AND DISASTER EVACUATION PROCEDURES, USE OF EMERGENCY EQUIPMENT AND NOTIFICATION PROCEDURES. SPECIFIC REQUIREMENTS OF THE OSHA HAZARD COMMUNICATION STANDARD FOR THE SAFE USE AND HANDLING OF HAZARDOUS MATERIALS AND THE PROPER DISPOSAL OF HAZARDOUS Page 2 [ I I Held for Future Use Held for Future Use -6- 10/26/2001 ~. - - - DD VA OUTPATIENT CLINIC SiteID: 015-021-000268 Manager : Location: 1801 WESTWIND DR City BAKERSFIELD BusPhone: Map : 102 Grid: 26B (661) 652-1801 CommHaz : Low FacUnits: '1 AOV: CommCode: BAKERSFIELD STATION 01 EPA Numb: SIC Code:8093 DunnBrad:95-652-1504 Emergency Contact / Title Emergency Contact /. Title GAYLE DEBOOM / LEAD CLINICIAN DARLENE TIw~,Smolá :';.a.f<'g>{fE MANAGER Business Phone: (661) 632-1801x Business Phone: (661) 632-18Ò1x 24-Hour Phone : (661) 663-4456x 24-Hour Phone : (661) J ~ ~ -4 '7Ð3x 'ì7àJ.~ Pager Phone (661) 634-8921x Pager Phone - ,......A : : T--r-di ~.:.n~l~ Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (661) 652-1801x MailAddr: 1801 WESTWIND DR State: CA City : BAKERSFIELD Zip : 93301 Owner DEPT OF VETERANS AFFAIRS, US GOVT Phone: (661) 652-1801x Address : 16111 PLUMMER ST State: CA City : SEPULVEDA Zip : 91343 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: One Unified List ì All Materials at Site ì p= Hazmat Inventory p== Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP I, F P IH F IH DH Do hereby certiiy that I have G G 460.00 FT3 Min 2500.00 FT3 Low NITROGEN OXYGEN (Typs or print name) reviewed the attached hazardous materials manage- and that it along with ment plan for (Name of Business) any corrections constitute a complete and correct man- agement plan for my facility. Signature Date -1- 08/16/2001 i 'i' e e VA OUTPATIENT CLINIC SiteID: 215-000-000268 Manager : Location: 1801 WESTWIND DR City BAKERSFIELD /8)(: /)AþJ' / 5 2000 BusPhone: Map : 102 Grid: 26B (805) 652-1801 CommHaz : Low FacUnits: 1 AOV: / - CommCode: BAKERSFIELD STATION 01 EPA Numb: Emergency Contact ~t8ÞðMTitle DR ALAN I'AWLOW b(J.~Jt. ï CHIEF MED C'í'R D Business Phone:~/(~) 632-1801x 24-Hour Phone :6bJ(8f15i ~5 2093x Pager Phone () (gl." 3 -:.. <I 'f 5 to X f.¡¡(g( 4- gq;}...t SIC Code:8093 DunnBrad:95-652-1504 t( ¡... ej'le 0 I t< Emérgency Contact / Title RODER'!' DENNE'í''ì' b/;// ADMN or OFFICBR Business Phone: (~) 632-1801x 24-Hour Phone :~(~) 399-4753x Pager Phone (It 4,;1 ) & '3 't - 8q95 x Fire Press ImmHlth DelHlth Hazmat Hazards: Contact : MailAddr: 1801 WESTWIND DR City BAKERSFIELD Phone: ( State: CA Zip 93301 x Owner Address City DEPT OF VETERANS AFFAIRS, US GOVT 16111 PLUMMER ST SEPULVEDA Phone: (805) 652-1801x State: CA Zip 91343 Period Preparer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: One Unified List ì All Materials at Site ì SpecHaz EPA Hazards DailyMax MCP F IH DH G 2500.00 FT3 Low F P IH G 460.00 FT3 Min p= Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name... OXYGEN NITROGEN I, QOv~ Ie. Lù })J3oo.-.--. D© h~V'®tQ)y OOñìå~ ~h~ ~ haM® (Typa or print nam&) reviewed the attached hazsmoos mtal~®U'Ûtal~$ manªQ®~ ment plan 101' BoJ\u.,~~'d CO')~~~~alf~~~ (NÐme of Bunlneca) any corrections constituR~ ~ rompl<SJ~€I ®R'iJd OOIT®d mtatR'iJ- agement plan 1(Ç1)fí' my ~©öU~. fI.. q /;s & . , 10 12/21/1999 · .. e - F VA OUTPATIENT CLINIC f= Inventory Item 0001 F= COMMON NAME / CHEMICAL NAME OXYGEN SiteID: 215-000-000268 9 Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit SW CORNER Map: Grid: CAS # 7782-44-7 - TYPE Pure PRESSURE Above Ambient TEMPERATURE Ambient CONTAINER TYPE FIXED PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 2500.00 FT3 Daily Average 2500.00 FT3 %Wt. RS CAS # 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low f= Inventory Item 0002 F= COMMON NAME / CHEMICAL NAME NITROGEN Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit NE DENTAL CLOSET Map: Grid: CAS # 7727-37-9 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE FIXED PRESS. CYLINDER Largest ,Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 460.00 FT3 Daily Average 460.00 FT3 HAZARDOUS COMPONENTS ~ No CAS # I 7727379 I %Wt. I 100.00 Nitrogen HAZARD A E TS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min SS SSMEN -2- ' 12/21/1999 .. e e F VA OUTPATIENT CLINIC I . ' f= Notif./Evacuation/Medical Agency Notification Ltltû CLln ItA C£f7 oS ¡' ,e- M M CLC¡¿¡¿ CHIBF, MEDICAL DIRECT0R AND ADMINIOT~~TIVE OPER~TIOI10 OFFICER ARE THE IMMEDIATE EMERGENCY CONTACTS FOR OUTSIDE AGENCIES. THEY INITIATE AN EMERGENCY CALL-BACK CASCADE PROCEDURE FOR ALL STAFF VIA TELEPHONE. ADDITIONAL NOTIFICATION OF THE DIRECTORS OFFICE AND EMERGENCY COORDINATOR AT THE VA MEDICAL CENTER, BErUL\TEM OCCURS BY TELEPHONE. W~ST /A}$ frhqde S SiteID: 215-000~000268 ì Fast.Format =¡ Overall Site ì 02/01/1993 Employee Notif./Evacuation 02/01/1993 EMPLOYEES IN THE CLINIC ARE NOTIFIED OF A DISASTER OTHER THAN FIRE THROUGH THE OVERHEAD PAGE SYSTEM. FIRE ALARMS RING THROUGHOUT THE FUILDING AND THE SECURITY DESK IS NOTIFIED BY "FIRE WATCH" OF THE EXACT LOCATION. COMPLETE FACILITY EVACUATION ,PLANS ARE IN PLACE AND EMPLOYEES ARE TRAINED ON PROCEDURES FOR STAFF AND PATIENTS. Public Notif./Evacuation 02/01/1993 PATIENTS IN CLINIC ARE AMBULATORY (NOT AN ACUTE CARE OR EMERGENCY FACILITY) AND ARE EVACUATED BY STAFF PER DISASTER PLAN. Emergency Medical Plan 02/01/1993 THIS IS AN OUTPATIENT CLINIC WITH SUFFICIENT MEDICAL STAFF ON HAND TO PROVIDE EMERGENCY MEDICAL CARE IF NEEDED UNTIL AMBULANCES CAN TRANSPORT TO AN ACUTE CARE FACILITY. -3- 12/21/1999 ,¡¡ e e SiteID: 215-000-000268 ì Fast Format ì Overall Site ì 02/01/1993 F VA OUTPATIENT CLINIC I p= Mitigation/Prevent/Abatemt Release Prevention EMPLOYEES ARE TRAINED IN THE SAFE HADNLING AND USE OF ALL NON-REPORTABLE QUANTITIES OF HAZARDOUS CHEMICALS. CONTAINERS OF SUCH MATERIALS ARE LESS THAN A GALLON AND MINIMAL QUANTITIES ARE ON HAND. BULK STORAGE IS MAINTAINED AT VAMC SEPULVEDA WAREHOUSE. Release Containment 02/01/1993 SMALL NON-REPORTABLE QUANTITIES OF HAZARDOUS FLAMMABLE LIQUIDS ARE STORED IN APPROVED FLAMMABLE STORAGE CABINETS WITHIN THE SITE. SUCH CABINETS ARE DESIGNED TO CONTAIN A LEAK AND PREVENT RELEASE. THE COMPRESSED GAS OXYGEN CYLINDERS ARE LOCATED AT THE EXTERIOR OF THE BUILDING AND ARE CHAINED IN PLACE. ADDITIONAL COMPRESSED GAS NITROGEN CYLINDERS ARE LOCATED IN AN ENGINEERING CLOSET NEAR DENTAL CLINIC AND ARE CHAINED IN PLACE TO PREVENT Clean Up 02/01/1993 ALL LABORATORY AREAS ARE REQUIRED TO HAVE CHEMICAL SPILL KITS CAPABLE OF HEADLING SPILLS OF 1 TO 2 LITERS OF LIQUID AND EMPLOYEES ARE TRAINED IN THE METHODS OF CLEAN-UP. NO REPORTABLE QUANTITIES OF HAZARDOUS MATERIALS ARE MAINTAINED AT BAKERSFIELD, EXCEPT FOR THE COMPRESSED GAS OXYGEN AND NITROGEN CYLINDERS. Other Resource Activation -4- 12/21/1999 e e SiteID: 215-000-000268 ì Fast Format ì Overall Site ì I F VA OUTPATIENT CLINIC I f= Site Emergency Factors ¡== Special Hazards Utility Shut-Offs 02/01/1993 A) GAS - GAS METER AT SE CORNER OF BLDG B) ELECTRICAL - MECHANICAL/ELECTRICAL ROOM SW CORNER NEAR EMERGENCY GENERATOR C) WATER - WATER METER AT SE CORNER OF PROPERTY AT CURBSIDE. D) SPECIAL - OXYGEN TANKS AND SHUT-OFF MANIFORLD SW CORNER OF BLDG EXTERIOR Fire Protec./Avail. Water 02/01/1993 PRIVATE FIRE PROTECTION - THE FACILITY IF SULLY SPRINKLERED AND CONNECTED TO A 24 HOUR FIRE ALARM MONITORING SERVICE (TEL-TEC), 18 ABC FIRE EXTINGUISHERS LOCATED THROUGHOUT, 4 SMOKE DETECTORS CONNECTED TO AUTOMATIC FIRE WINDOWS IN PHARMACY AND CLINICAL CARE AREAS. NO ON-SITE RESPONSE TEAM. NEAREST FIRE HYDRANT - FOUR FIRE HYDRANTS LOCATED AT EACH CORNER OF PROPERTY PARKING. Building Occupancy Level -5- 12/21/1999 ~ " ,~ e e F VA OUTPATIENT CLINIC I F Training Employee Training SiteID: 215-000-000268 ì Fast Format ì Overall Site ì 02/01/1993 WE HAVE 51 EMPLOYEES AT THIS FACILITY. YES WE DO HAVE MSDS SHEETS ON' FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY AND DISASTER TRAINING IS FOR EACH NEW EMPLOYEE AND ANNUALLY AS A REFRESHER. THIS TRAINING IS PERFORMED BY SAFETY SPECIALISTS AND INDUSTRIAL HYGIENISTS FROM THE SEPULVEDA VA MEDICAL CENTER. AS A FEDERAL FACILITY, ALL TRAINING IS IN ACCORDANCE WITH FEDERAL OSHA STANDARDS AND VA POLICY AND INCLUDE FIRE AND DISASTER EVACUATION PROCEDURES, USE OF EMERGENCY EQUIPMENT AND NOTIFICATION PROCEDURES. SPECIFIC REQUIREMENTS OF THE OSHA HAZARD COMMUNICATION STANDARD FOR THE SAFE USE AND HANDLING OF HAZARDOUS MATERIALS AND THE PROPER DISPOSAL OF HAZARDOUS Page 2 L I I Held for Future Use Held for Future Use -6- 12/21/1999 ;- CUST TYP~ NO. E 5 - 3ba 5 MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE bQ_cyy; NEW ACCOUNT ADDRESS CHANG6 CLOSE ACCT i : FINANCE CHARGE I ; OTHER ADJ i CUSTOMER NAME VA OuTfd-î ei\+ C\ ì (\ ~ C-- MAILING ADDRESS 1~D\ W~~-\-W\ (\J Of. CllY .ß:tle(~~, fjJ STATE r .A ZIP CODE q3~(j I SITE ADDRESS PARCEL NUMBER (IF APPUCABLE) ADJUSTMENT ¡ CHG DATE CHARGE CODE I -\- SSDD REM~KS: ~'IS ~ *h~~~~~ ~~(~ ~~~f +or ~\~~~\ ]¿r ~\~ s \ p J\ APPROVED BY ) "i \ ePARTMENT OF VETERANS AFFAIRS. Medical Center 16111 Plummer Street Sepulveda CA 91343 Iª- -rï= ,p::'r-~_r:r~\7r¡§~rl O. ls~J\.....'7 I L.. i! \v'>/' ì c:. f r. ."",\ ¡ --- '"---' ~ L.:::::::i I, I~ lfu'; DEC 2 1 1992 ¡¡ m , t·'f' , "' ., ,; ] ~ ¡ ~ By J ¡L=_".,",~~::=:---~-~..,.",=-- In Reply Refer To: becember 16, 1992 Barbara Brenner Bakersfield Fire Department Hazardous Materials Division 2130 "G" Street Bakersfield, CA 93301 Dear Ms. Brenner Enclosed please find a completed HMMP for the Department of Veterans Affairs Bakersfield Outpatient Clinic cited in your December 12, 1992 letter. This HMMP currently contains only the compressed oxygen and nitrogen gas tanks as hazardous materials on site. Although several other flammable liquids are present they are currently maintained below reportable quantities and in approved flammable storage cabinets. Until such time as the supply area of the clinic is staffed to maintain a larger inventory of these materials, they are supplied on demand from our warehouse at the VA Sepulveda hospital. We do not anticipate maintaining reportable quantities of these flammable materials at the Bakersfield site. Please contact me at (818)891-7711 ext 7773, if any further information is needed or if the HMMP needs to be updated. Sincetely, if). " / /~~/ i '" /r/1- : / 'Kerr B. Clegg, P~., Chief, Environmental Health and Safety Director's Officè- (001 EHS) ~-- ...'>-, ':" ~~. . . Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: \ \)d- ?Jo P (ø.. V 1 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Ba~ersfield Outpatient Clinic, Department Of Veterans Affairs ~ LOCATION: 1801 Westwind Drive MAILING ADDRESS: 1801 Westwind Dr1ve CITY: Bakers fi e 1 d STATE: ~ ZIP: 93301 PHONE: (805) 652-1801 DUN & BRADSTREET NUMBER: 95-6521504 SIC CODE: 8093 PRIMARY ACTIVITY: Hedical Outpatient Services Sepul veda VA~1C OWNER: Depadment of Veterans Affairs, U.S. Government 16111 Plummer St., Sepulveda, CA 91343 MAILING ADDRESS: SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS, PHONE 24 HR. PHONE 11.'",\ Chief, t1edical 1. Dr; Alan Pawl ow Center Di rector {805)632-1801 (805) 665-2093 Adm i n i s t ra t i ve 2. Robert Bennett Operations. Officer (805)632-1801 (80F;) 1qq-4753 1. FD1590 · Bakersfield Fire Dept. . Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN. ¥ -", .... " ¡:; SECTION 3: TRAINING: NUMBER ÒF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: 51 BRIEF SUMMARY OF TRAINING PROGRAM: Yes Sa~ety _a~d .dis~ster training is for each new employee and annually as a refresher. Th1S tra1n1ng 1S per!ormed by Safety Specialists and Industrial Hygienists from the Sepulved~ VA Med1cal Center. As a federal facility, all training is in accordance \'/lth ~ederal OSHA standards and VA policy and include Fire and Disaster EvacuatlOn Procedures, use of emergency equipment and notification procedures. Specific requirements of the OSHA Hazard communication standard for the safe:-.use·'and:Jhandl ing of hazardous material s and the proper disposal of hazardous wastes are also addressed. ' ~ SECTION 4: EXEMPTION REQUEST: .. I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6,95 OF THE "CALlFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS, WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES, OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: 1. \::>11'. µ~ f J-,¥"'I- CERTIFY THAT THE ABOVE INFOR- MATION IS ACCUR!A.TE, I UNDI1RS/rAND THAT THIS INFORMATION WILL BE USED TO FULFILL N1Y FIRM'S OBLIGATIONS UNDER THE "CALlFORNIA HEALTH AND SAFHY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCU ATE INF ATION CONSTITUTES PERJURY. Chief, Environmental Health & Safety (OOlEHS) Sepulveda.VAMC 12/14/92 I TITLE DATE 2, cr 1 rr,( -' . ~"l ~ . Bakersfield Fire Dept. . Hazardous Materials Division '. .' HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: Employees are trained in the safe handling and use of all non-reportable quanities of hazardous chemicals.:Contãiner,s ôf such materials are less than a gallon and minimal quanities are on hand. Bulk storage is maintained at VAMC Sepulveda Warehouse., B, RELEASE CONTAINMENT AND/OR MINIMIZATION: Small non-reportable quanities of hazardous flammable liquids are stored in approved flammable storage cabi.nêts"\'Jithin the site. Such cabinets are designed to contain a leak and prevent release. The compressed gas oxygen ,- I cylinders are located at the exterior of the building'and are chained in place. Additional compressed gas nitrogen cylinders are located in an engineering closet near Dental 61inic and are chained in place to prevent release. C. CLEAN-UP PROCEDURES: All laboratory areas are required to have Chemi'cal Spill ,'Kits capable of handling spills of 1 to' 2 liters of liquid and ef¡i'l)1oyees are trained in the methods of'élean-up. No reportable quanities of hazardous or acute11' hazardous materials are maintained at Bakersfield, except for the compressed gas oxygen and nitrogen cylinders. . . SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS ATYOUR FACILITY): NATURAL GAS/PROPANE: c. ",'< . ;Ga~ Met~i~t SOUTH EAST co~ner of buildinq " ELECTRICAL: t1echanical/.§lectrical Room SOUTH ~EST corner, near Emergency Generator. WATER: Water t1eter at SOUTH EAST corner of propertv at curbs ide. SPECIAL: Oxygen tanks and Shut-Off t1anifold SOUTH WEST corner of building exterior. LOCK BOX: YESŒo) IF YES, LOCATION: ---- -- ---- SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: ¥h~ f~Q11ity is. fully sprinklered and connected to a 24 hour firß alarm monitoring service (Tel.:Têc), 18 ABC fire extinguishers located througho'dt-~ 4" smoke detettors'èonnected .tò automati cfite'·w1;ridows.d n: Pharmacy 'and:.: clincal care areç¡.5.1 No on-site reSl20nse team. - ~r."-· WATER'AVAILABILlTY (FIRE HYDRANT): . Four fire hydrants located at each corner of property parking. "-c,,"",' ~" , ~ . Bakersfield Fire Dept. . Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: Bakersfield Outpatient Clinir.: npr;!rtment Of Vptertlns Affairs SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AG-ENCY NOTIFICATION PROCEDURES: " Chief, Hedical Director and Aqministråtive Operations Officer are the , immediate emergency contaèts for outside agencies. They initi'ate an ~mergency Call-back Cascade Procedure for all staff via te,lephone. ·Additional notification of the Director's Office and Emergency Coordinator at the VA Medical Center, Sepulveda occurs by telephone. B. EMPLOYEE NOTIFICATION AND EVACUATION: Employe~s in the c11niç are notified 6ft a disaster other than fire through the overhead page system. Fire alarms ring throughout the building and the security desk is notified by "Fire, l~a.tch" of the exact location. Comple'te facility evacuation plan~,' are' i n placE'dànd':empl ò)êes {aretrâ iinèd-~óilþròcedGres f~~' staff' ånd, patients. C. PUBLIC EVACUATION: Påtients in clinic are ambulatory (not an acute ca~e or emergency facility) and are evacuated by staff per disaster plan. D,' EMERGENCY MEDICAL PLAN: This is an outpatient clinic with sufficient medical staff on hand to provide _emergency medical care if needed until ambulances ,can transport to an acute care facility. ~ FDlt·, CITY OF BAKER.SFIELD pageJO.' HAZARDOUS MATERIALS INVENTORY D Farm and Agriculture ~ Standard Business NON - TRADE SECRET BUSINESS NAME: 8~~~-helj o ltp ~l .,r. e",..i C.L\^.-\~ OWNER NAME: V If,} ,\It fOiUI- L t-rt2.. DV (:1 NAME OF THIS FACILITY: LOCATION: I~O( W~~/H1 b T.JíI - . ADDRESS: 'loll{ p'::Jlvw...fM"".e.. 5T, , STANDARD IND. CLASS CODE: ~Oq3 CITY, ZIP: 'ß ~ tL-€~<;;. ~ '1 ~ 30 f CITY, ZIP: S~_ v\Vt-M- WI. Co? ''341' DUN AND BRADSTREET NUMBER/FEDERAL ID PHONE #: <í?c:> 6.- - (p~'7.. -I<t.()\ PHONE #: <£','1> - ~q / -7ï I \ :2 ~ - it -?: -z:.- - 1 ~!:? Y: PROPER CODES i I I 6 12 r: 14 Location Where Names of Mixture/Components Stored in Facilit See Instructions .sw CO I!.. ftfriR.. ~YGC¿JV Physical and Health Hazard C.A.S. Number Component' 1 Name , C.A.S. Number -- (Check all that apply) ~ Qšl Sudden Release o Reactivity 0 lonnediate 0 Delayed Component' 2 Name , C.A.S. Number Fire Hazard of Pressure Health Health Component' 3 Name , C.A.S. Number / ~ "1wO I 4lo0 I 10;000 I PT3 I 3(P~ ~ ~ InJ Nf:- l) e/lJ'f' ft-L CJ Cà £1' fJ L-r~O 6£/IJ Physical and Health Hazard C.A.S. Number ?7~7-3?-9 Component' I Name' C.A.S. Number (Check all that apply) t=J Fire Hazard ~ Sudden Release o Reactivity o lonnediate 0 Delayed Component, , 2 Name , C.A.S. Number of Pressure Health Health Component , 3 Name , C.A.S. Number =r=J I I I I c=r=J CJ Physical and Health Hazard C.A.S. Number Component . 1 Name , C.A.S. Number (Check all that apply) 0 o Sudden Release 0 Reactivity 0 Ionnediate 0 Delayed Component' 2 Name , C.A.S. Number Fire Hazard .- of Pressure Health Health Component . 3 Name , C.A.S. Number =r=J I I I I c=r=J LJ Physical and Health:Hazard C.A.S. Number Component . I Name , C.A.S; Number (Check all that apply) 0 Fire Hazard 0 Sudden Release 0 Reactivity 0 Ionnediate [:1 Delayed Component' 2 Name , C.A.S. Number of Pressure Health Health Component . 3 Name , C.A.S. Number I I I EMERGENCY CONTACTS UD\I. ~. ?c.wl aW r M. ~, 1:>1 (U>·~f("(' {p(K- 20q~ A-O I V<H-It'i'a. :>'ìQ-J.f1S'1 Name Title 24 Hr. Phone Trtle 24 Br PhOnE Certitication (READ AND SIGN AFTER COMPLETING ALL SECTIONS) I certify under peanlty of law that I haver personally examined and am familiar with the information submitted and that based on ray inquiry of thOI individuale responsible for obtaining the information. I believe that the submitted information ie true, Kerry B. C1E 2..-- NAME AND OFFICIAL TITLE OF ;;:.,- . ~ . . CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S. D. JOHNSON FIRE CHIEF ~øw'-uf l-//-C(;;r- December 12, 1992 _ ,,~11· . ,¡ \ Û,.~Ü,V\ i ,,\_ qJ-,J O~ ". t \3 "if V--fL(, Ò 2101 H STREET BAKERSFIELD, 93301 326-3911 Attention: Administrator NOTICE OF VIOLATION AND SCHEDULE FOR COMPLIANCE =============================================== In the inspection of your business the Veterans Affairs Outpatient Clinic located at 1801 West wind St., Bakersfield, CA 93301 on 5-12-92 the following hazardous materials regulation violations were identified: // v 1. A hazardous materials management plan and inventory had not been submitted for the storage of nitrogen and oxygen indicated on the building plans. VIOLATION OF CH. 6.95 CALIFORNIA HEALTH AND SAFETY CODE SEC.25503.5 (a) Any business, except as provided in subdivision (b), which handles a hazardous material or mixture containing a hazardous material which has a quantity at anyone time during ~he reporting year equal to, or greater than, a total weight of 500 pounds, or a total volume of 55 gallons, or 200 cubic feet at standard temperature and pressure for a compressed gas, shall establish and implement a business plan for emergency response to a release or threatened release of a hazardous material in accordance with the standards in the regulations adopted pursuant to Section 25503. The above violations must be corrected by January 11, 1993. At the time of the inspection, the Doctor whom I spoke with indicated that the facility would be in full operation by August or September of 1992. The hazardous materials business plan and inventory should have been filed within 30 ~--:-- .q- . . days of the date that the hazardous materials arrived on site. A packet of forms to be used to complete this plan are enclosed. Failure to correct these violations will result in enforcement action. The department will schedule a re- inspection of your facility to verify compliance. If you have any questions regarding this notice, please contact me at 326-3979. Sincerely, ~~~~n:.J~~ Barbara Brenner Hazardous Materials Planning Technician cc: Ralph Huey, Hazardous Materials Coordinator Michael Allford, Deputy City Attorney . . CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S D. JOHNSON FIRE CHIEF December 17, 1992 2101 H STREET BAKERSFIELD, 93301 326-3911 Mr. Robert Bennet, Administrator Bakersfield V.I.A. Clinic 1801 Westwind Drive Bakersfield, Ca. 93301 RE: Medical Gas System Dear Sir; Enclosed is a copy of a report from Integrity Medical regarding the medical gas system at your facility. This completes the deficiencies that have been noted since the first inspection. The clinic is now released from any restraints of use on the medical gas system. This still leave the nitrogen gas system for the dental section open for inspection. Please fee free to contact if we can be of any assistance. Yours Truly, Richard Harger, Captain Fire Safety Control · Bakersfield Fire De~ Hazardous Materials Divis~ J 0- 4-91 ~,,\~!~ ~1,1~\'i.I..D P¡~""""~ $l~~ ' -?\ ê~;; .~J¡ ;,~ S\~ - ~ ~~== -=, ',. \ ~,. _..~ " ~..... ........ ; y ~:-..~ CA~ÝJ¡JI ~ QJ¡ll-;~· TO: BUILDING DEPT. ¡k9f1-ci<.d s-- ~d. -4 f . f3c:~Llvr~~\D-A-\ t\.~ --tv rncµ,~ \J-- ~ 6M- -~-\vr ciÐes rJcrt -~~ýpe.ç Th v<Þf,'( ~.~ U vf ~ J,u,-rt'J ,~/¡¿rJJ 1 ~ ÁÆ. 1>.LAA. --tv b.t- u.... ~.1~ J~ u<:r- Ó BUSINESS NAME V~IUOJt\Jj W(Á~rÎ) lðo \ L~)~T \.ù ~ r\& - LOCATION CcmûlL"T ':. 130'0 ~* ~S \\Þît'\.\()\~-lO" ~ ~j,j~~ ~\\J¿' ~~ \00 ct3~ \ V~ ;ì,CIY\.-S ~ q t. let I ~ D\j~-n(lj1ï"'" ();I\J\'(' ~ STATUS OF HAZ MAT REGULATIONS I. I2Sf Required to complete a Hazardous Materials Business Plan D Hazardous Materials Business Plan Complete II. D Risk Management & Prevention Program Required D Risk Management & Prevention Program Requirements are being met - OK to issue permit D Risk Management and Prevention Program has been approved, OK to issue Certificate of Occupancy, III. D No Hazardous Material Requirements. IV. D All Hazardous Materials Reporting Requirements Complete. comm.ents:.. V\()...h..l\ '\. k\.0;'rù.t9-' (Y\lLl~í ..(~ ì h.c\c (' 0 'í ~~ l'/\cU1¥cI_ l-\DfU~ ~ N~f'¥\.' <\- (Å-"~?"<¡F r<\ \ f l£.d ~ CXLùjY^-^v..r .. ," ~ ~...y -l1 \ ('\D~ ~ / \'d-,<ì\J ~~ Date FD 1655 Rev 1/90