The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN 5/1/2001 Per It to Operü.te Hazardous Materials/Hazardous Waste Unified Permit - LOCATION: e Issued by: CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: It! Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SERVICES' 1715 Chester Ave., 3rd Floor Approved by: Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: CA 93309 June 30, 2003 ~~~ úJ ~ ~ -- ::;e~~~~ j¿~M Business Address: ~'l¿) / e- SITE I [) .::#;;:2.1 c.¡ I FACILITY DIAGRAM r 1 I/I-::-~;f//r£-..ý /k<;/'/ ~L wff/ fi!Ç LA/. ~-§rE, C / I t-.~ ~ ... p ~~: EJ~H ; I /,' l{'~, ~ ~ z ',~;~ J ~ FJ :' .. " ',01 9 " . .~ ----;;---'-, ~ < I " : ' :1 ~ 13- N ~ ' " ~ I ~ j - . . 0, ',1 o . .; .. 0\ ~ ' 8 ~ - ã. ~ ~ " .- (] - VI .. '0 f ~ c .. .- ~ .. :Q ~ ë .2 ~ u c >- o .. 1) E VI VI ~ .. o D. .. !'! ;¡ 8 j~ Z.... 2 ~ ...,... VI cr VI VI ~ f1 " " U1 ~ Ll ~ j' t-~-' rm _ OVOU 3HllS . ~:~~9TjjJ - ~:--~, ' r0.':-.\\'0è,\\ \\ \\ \ \ ':-. \\ \<\ í(!fØ: ~ ~ f I U\\\\\\\\\,\\\\\\\\\\\\\) ~\) . ~ j ~~~~ ~®~' l&~~ rr= I ~~1 ; ~\ill~\~~~\\\ffilli5ì tt; '$. I /) ~ Ls\\\\\\ \ \\\\ \\\\\\\J ===--r ~~~\~~~ mmm _ ~ ~\~~~~'W d~¡HI~Ijlll~ : - 1,,- -- :.") ~ -- - . L o '=-.:':::1 = ~ IX u ~ ~ u .. u ~ . D rI , o' o II. , . /~\\'ù\ \\\\ \.\Sì ~\\\\\'\\\\\\\\~\\\\\J.: ~ ~ ~g . f ~~.'@ ~ ~~~~.'" :, ~\\\V ./ ~~~~~ 3~/ -~ì ~~~~. " -;:- ~\ .~ 20 ~ ..........-., ~ x ,...... ~ ~ /------- '" / - ~/~ ~ -- ...--- ,/ , , , " I ,..-' ~ . , I ~ ], -..... 11(j~ l ~ ~ ~.¡ ~ ~ -~ ~ lß r¡ Q ~ .,...... -..... ~~ tl rs~ JJI i ff}::: eJ<., s v L ,0 . .~, ~~.~ e :~e?s~~~A~ Business Address: q1' ¿? / e FACILITY DIAGRAM r I/I-:~ /1/ /T~.ý /-k/.<;// /r}-L ú/If/ TF a-/. r5r£", C- / c SiteMap: Fire Prevention Plan Emergency Action Plan i' Practice Name PIPKIN VETERINARY HOSPITAL ..' Adqress , ~¡ 4701 WHITE LANE, SUITE 'C BAKERSFIELD, CA 93309 Telephone (805) 831-8900 Owner(s) WILLIAM M. PIPKIN, D.V.M. i- .!, -"1. :.- ;'-~'~ ~1-,'-" ~--·,i_~.:, - - .:~ .-,[ ..... ~, -~'"]_~,~ :, -i, _ ':¡" ----11 ~ :~_:,J,: :: i, . .';," '.~':,' .::~:. . , ". , 1 ~_ r .~-..:'f~·J~~~;~~ ::~-~L~~--~-·-·~-~:f~~~~~,·, ~~f~:~~---E~ri -~~r. .~n:f·~F:. ,~:f:·:,;·:·~--:·=·t~.~,-:· .;:---:::-:=1.: '~ .. '-,-- +.. . ~-!-~~--~-~~.'- . 1 ' i-' ....~ n, -" '.. i<1iiNiJ.n.s: 11) I . t.; . , .,.. _ ,,1__... ... -;" -.. -~..--.._.;,._._- ~- .. ..., ' ; .... .'t E .._~._ ._~ .._ ~ -·-r--·-·--·;·,-"-- -_l>XAH..Z:_..·-i__+_·,t '. -;....;-. SUBC1ER't.. -Z, -.lSbUtT¡cW.;.-- __._ ~-~~4~-~::~-~.~-.-\fi~~~-;.:It~:,l:-~-~---:~.t=l~-L~ ..... ~.~ -" ~-, ---t-.-.. -~ ¡,.,-., - ._~-_L_'-m·-1_· -_. r-.., ..'.-'.-"....-.,.---;- ì I ~_-;- ,J,_, '._ J...._ I :. ·t-.. r .. ~ ~-Lj,~' ; 05_.: :~t,.._· :1' ;~' . ',' ;.~ .. -'--t.- . ·..-r·-·--f----L-- .,-L-L~+!. .' ... '.-:~!,'+~__-=- I. .. . :.... -i-~+- '_u_,. .L...-L_!._l_-I-:-+:~F_~~_..· :-~_" ---::;--::::.. : ~_., .....1. _. .. ... ,__ .-. .-. :--,--+ --t- .. _!OFF/c.£._ ...i....--1-_ '.. RltDI(jJ.DIiY ~~~.___." _'. .,~~_.,,-,...i___~__ .'-;-1--.- ----,~ ltC.y,_ 'r-- --i.! _ -.. __ ~u_~__ _ _:__ , !, ¡ i.-: i.·::--.i-=Lu). .. i : -- -. ! -. ___}'_h" .~____ i ___", I. J ,-1.....1__1,; , I ::t:T··r ., .. .. ,-. , I-!, -i .c:: I ; ...i. ..j_L~ "_H ~ t : r .. --+----__ -I.. .-.I._L._.! ..__1. .. 'j" .~' ._-~' ., .1.,. ~. "f -~. I" --~- ..,~t, .-.~ .__.~.;--. .__i._~ ... .: - -. ..... .~... -:.___ _, L_:- . -- . _. r-- SYMBOLS: 1) FIRE EXTINGUISHER 2) WATER SUPPLY ~+ -it x erj.:~,)¿{.¡;~ 5 3<;,-1 ,t::.Ðý) h<hJîe/ t N ,'I' J,I,,/ REMIT AND MAKE CHECK CITY OF BAKERSFIELD PO BOX 205ï BAKERSFIELD ~66i) 326-3642 PAYABLE: TO: .... \. , . CA 93303-205ï TOT AL DUE: $123. 00 -*-2Ja5/~6S &.5ed /7ÞIO / PLEASE DO NOT STAPLE, PAPER CLIP OR TAPE CHECK TO REMITTANCE: ' ' ~ -"._- ..-- - 6210 PIPKIN VETERINARY HOSPITAL 4701 WHITE LANE, STE, C 805-831-8900 BAKERSFIELD, CA 93309 DATE .,;¿,.;2.¡' ~t:J :5 16-244382 1220 PAY TO THE ORDER OF ~~ d ~~hd4 áL .~4'~d Ø7~~/jL- . Wells Fargo Bank. N,A, California ,.. www.wellsfargo.com .3371.,;L ~¿7 ... I $ /.4'3~ -- A .....,,- DOLLARS l.!.J ~,;,_ 11100 b 2 ¡. 0 III I: ¡. 2 2000 2 ~ 71: 0 2 c:¡ 0 0 U; M' FOR .,' ..~ . , " " .õ> -~ ·e - PIPKIN VETERINARY HOSPITAL SiteID: 015-021-002141 Manager : WILLIAM M PIPKIN D Location: 4701 WHITE LN C City BAKERSFIELD usPhone: ap : 123 rid: 14D (661) 831-8900 ComrnHaz : Minimal FacUnits: 1 AOV: CommCode: BAKERSFIELD EPA Numb: Emergency Contact / Title Emergency Contact / Title WILLIAM M PIPKIN / DVM / Business Phone: (661) 831-8900x Business Phone: ( ) - x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: React Contact : Phone: (661) 831-8900x MailAddr: 4701 WHITE LN C State: CA City : BAKERSFIELD Zip : 93309 Owner PIPKIN VETERINARY HOSPITAL Phone: (661) 831-8900x Address : 4701 WHITE LN C State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Pre parer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Di;r-ectives: One Unified List l All Materials at Site l f= Hazmat Inventory f== Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP WASTE FIXER I, Do hereby certifYlthat I have L 5.00 GAL Min (Type or print name) reviewed the attached hazardous materials manage- ment plan for (Name of Business) and that it along with any corrections constitute a complete and correct man- agement plan for my facility. Signature Date -1- 05/01/2001 · e e F PIPKIN VETERINARY HOSPITAL p= Inventory Item 0~01 = COMMON NAME / CHEMICAL NAME WASTE FIXER SiteID: 015-021-002141 l Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit ßa..:;/-h ,¿J CJ rY"I Map: Grid: CAS # STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 5.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 5.00 GAL Daily Average 5.00 GAL %Wt. I Silver HAZARDOUS COMPONENTS CAS # I 7440224 ~ No TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min HAZARD ASSESSMENTS -2- 05/01/2001 e e F PIPKIN VETERINARY HOSPITAL I ~p= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-002141 ì Fast Format ì Overall Site ì 05/01/2001 TO NOTIFY OF EMERGENCY???????????? g :J-7-tj(íI Employee Notif./Evacuation 05/01/2001 HOW ARE YOUR EMPLOYEES GOING TO BE NOTIFIED OF AN EMERGENCY??????????? 05/01/2001 HOW ARE YOU GOING TO NOTIFY THE PUBLIC OF AN EMERGENCY??????????? 05/01/2001 WHAT MEDICAL FACILITY OF DOCTOR WOULD YOU LIKE TO BE TAKEN TO IN CASE OF AN EMERGENCY?????????????? j//¿r. -3- 05/01/2001 e e F PIPKIN VETERINARY HOSPITAL I p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-002141 '1 Fast Format '1 Overall Site '1 05/01/2001 PREVENT A RELEASE OF THE WASTE FIXER???????????? &:, 1VJ7'rt' ~ Release Containment 05/01/2001 HOW WOULD YOU CONTAIN A RELEASE OF THE WASTE FIXER??????????? ~ ,¿J 5 .11 fji- Clean Up 05/01/2001 HOW WOULD YOU CLEAN UP A SPILL OF WASTE FIXER???????????? (~ S t t/I ILL ¡- Other Resource Activation -4- 05/01/2001 e e I IF PIPKIN VETERINARY HOSPITAL I~ Site Emergency Factors [:: Special Hazards Utility Shut-Offs SiteID: 015-021-002141 ì Fast Format ì Overall Site ì I 05/01/2001 A) GAS - N END OF BLDG B) ELECTRICAL -N END OF BLDG C) WATER - N CENTER OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 05/01/2001 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - (WHERE IS IT LOCATED???????????) Building Occupancy Level· ;1 -5- 05/01/2001 ., - ¡; 'i e e F'PIPKIN VETERINARY HOSPITAL I F Training Employee Training SiteID: 015-021-002141 ì Fast Format ì Overall Site ì 05/01/2001 HOW MANY EMPLOYEES DO YOU HAVE AT THIS FACILITY??????????? o NO MSDS SHEET ON FILE FOR WASTE PRODUCT. GIVE A BRIEF SUMMARY OF YOUR EMPLOYEE TRAINING PROGRAM: SeeS - Page 2 [ I I Held for Future Use Held for Future Use -6- 05/01/2001 'f- - ) e - PIPKIN VETERINAR 0 Y H SPITAL SiteID: 015-021-002141 = Manager : hILL.//l-Þ? Þ?, />/".:JK/A.!/ j)1//k-f BusPhone: (661) 831-8900 Location: 4701 WHITE LN C Map : 123 CommHaz : Minimal City : BAKERSFIELD RH'relVED Grid: 14D FacUnits: 1 AOV: CommCode: BAKERSFIELD STAT I N ØtPR 2 5 2001 SIC Code: EPA Numb: DunnBrad: .......~ , &..J.L . -- Emergency Contact / Title - / Title Emergency Contact WILLIAM M PIPKIN / DVM / Business Phone: (661) 831-8900x Business Phone: ( ) - x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: React Contact : Phone: (661) 831-8900x MailAddr: 4701 WHITE LN C State: CA City : BAKERSFIELD Zip : 93309 Owner PIPKIN VETERINARY HOSPITAL Phone: (661) 831-8900x Address : 4701 WHITE LN C State: CA City : BAKERSFIELD Zip : 93309 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 f== As Designated Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP WASTE FIXER R L GAL Min I, Do hereby certify that I have (Type or print name) reviewed the attached hazardous materials manage- meni plan for (Name of Business) and that it along with any corrections constitute a complete and correct man- agement plan for rAY facility. -1- 12/04/2000 Signature Date íÍ- ,< ~ e e F PIPKIN VETERINARY HOSPITAL p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME WASTE FIXER SiteID: 015-021-002141 ì Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit Map: Grid: CAS # STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum Daily Average GAL GAL %wt. I Silver HAZARDOUS COMPONENTS ~ CAS # I 7440224 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards . NFPA USDOT# MCP No No No No/ Curies R / / / Min -2- 12/04/2000 ~ i _/-:s - e CITY OF BAKERSFIELD - OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS, MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this fonn within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. ,0' 5. You may also attach Business Owner / Operator Fonn and Chemical Description Fonn(s) to the front of this plan instead of completing. SECTION 1. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA BUSINESS NAME: /}//(/4/ t/ê7é:;O/!/,ff/Gy' . ¥ /'/f} I ¿þs/ /,77j-¿- LOCATION: ú.J1-f- / ~ Á /l/ J 67lÇ: ~_ ./ MAILING ADDRESS: L- ""ÝnUtr CITY: ¿3~C;-ßP/&'Z.t? STATE: ¿1AzIP:~ONE: £¿;'/-j/6/~~7¿:iÓ PRIMARY ACTIVITY: ~7'è7Z/d~Y ~S'//~ / OWNER: kA¿L/~ /l4, ß/k'//f./'/2Jt/M r PHONE: ¿'~/-1"3..2-.2S-CJ? '---. MAILING ADDRESS: ð/l7t4e EMERGENCY NOTIFICATION CONTACT 1. ~ß//11Wµ, A/,e'/d TITLE BUS. PHONE 24 HR. PHONE ¿/"wdt::Z- ¿¿/--/.:J/-/rjðt? J~ 2. 1 e e HAZARDOUS MATEIDALS MANAGEMENT PLAN 1i_:'- ~¡ SECTION II.I: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: ,~ B. EMPLOYEE AND AGENCY NOTIFICATION: C. ENVIRONMENTAL RESPONSE MANAGEMENT: D. EMERGENCY MEDICAL PLAN: 2 .~ "i~/", ;.........~ e e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 11.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: B. RELEASE CONTAINMENT AND/OR MITIGATION: ,.' C. CLEAN-UP AND RECOVERY PROCEDURES: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROP ANE: ELECTRICAL: ~ h~ WATER: . SPECIAL: LOCK BOX: YES/NO ~A:hLTY 6-;v'þ> ðr /3t//L/)/¡t/''7 ¿ç;r-/O 4~ .4H/L/J /dç;. IF YES, LOCATION: PRIVATE FIRE PROTECTION/W A TER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): 3 e e "'-::..... .-~ HAZARDOUS MATEIDALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: .3 MATERIAL SAFETY DATA SHEETS ON FILE: YES BRIEF SUMMARY OF TRAINING PROGRAM: ,~ CERTIFICATION I, IIAtU~¡V? ¡v1, ~//'~~ CERTIFY THAT THE ABOVE 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 (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. TITLE 2--3/ó / DATE 4 't) rf Ilin\Ïeterlnary tfO~¡~1 - -- j - - WILLIAM M. PIPKIN, DVM -Veterinarian ~-- 4701 White Lâne, Suite C - I¡akersfield, CA 93309 (661) 831-8900 ---- --------- ------ - ~~--~--~- ---- -~- ..,."- # ;- .. e 3711 CITY OF BAKERSFIEL MEN OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ~{~ [d--Y 14 D 7~ (}(?(od FACILITYNAME ?(OK."J Vc?f'.- ~, ADDRESS 470 ( VCJ l+1 rG- uJ -t;a: <:..- FACILITY CONTACT Ï)(L flPl<.~,.j INSPECTION TIME INSPECTION DATE PHONE NO. BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~outine o Multi-Agency o Complaint o Combined o Joint Agency N'C-.J ORe-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate t.J (<..L Ct4C-d- 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 site?: ~Yes 0 No Explain: IlifMœ ~. Questions regarding this inspection? Please call us at (661) 326-3979 White - Env, Svcs, Yellow - Station Copy Pink - Business Copy Inspector: --""!. . "-.~- -- ~. "...~,,:,>,.:- - ~- ,..._~-y~~~- ' --~--- C~YOFBA~~:~~~m OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ~'b I d 37A 0 -' -¡,... . ----.~ . INSPECTION DATE PHONE NO. BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES t~ I., ICd FACILITY NAME 'Pf Ç>cú,J VC?f, ~(). ADDRESS 470' {..AJ 4-t-r-G- uJ -Þ: c::- FACILITY CONTACT ~(L frDf<.,.j INSPECTION TIME NL~ Section 1: Business Plan and Inventory Program !i-Routine o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Appropriate penn it on hand Business plan contact infonnation accurate WILL c.¥-G<.. Visible address Correct occupancy Verification of inventory materials Verification of quantities . Verification of location Proper segregation of material Verification of MSDS availability -~ , Verification ofHaz 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 White - Env, Svcs, Yellow - Station Copy Pink - Business Copy Inspector: Any hazardous waste on site?: 13-Yes 0 No Explain: rAI A) (lE F f/<.~ Questions regarding this inspection? Please call us at (661) 326-3979 e INSPECTION DATE u17/~ FACILITY NAME r,> I p¡'¿¡rJ v(3-'\'- &le>sP, TAl..-- Section 4: Hazardous Waste Generator Program EP A ID # <!.ÁL ocx:Jö G 'Z-~3 rzf-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 .,/ rLGA-se fRòVtfJ& 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 fTom land disposal /" C=Compliance V=Violation 4~~~:~~ Inspector: W {rJ'C-S Office of Environmental Services (661) 326-3979 WhIte - Env, Svcs, Pmk - Busmess Copy