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HomeMy WebLinkAboutBUSINESS PLAN 7/25/2000 / 'I I' , G ~ GOSFORD' -!fail,*'l' i \.\ ANIMAL HOSPITAL .' / ~~~ qb \ 1;{Slol fYb-vcQ ot ~- - 4")0 ( ;rw/uJ-fl fJ-1 \ ' /6;\ II '/': II ,II 11 j[ Ii I_I II ~- It <:96'6' NLIB P· . "..,..., , -, .' ~. . er .~if.~¡~~i:i.~,~.:ì~~i$0W\~f{;J:~:~;·;;.~~~'~ ':' ....~.·.(.,,~t:;0i~~~;~:~~'~{0~b\.}i;:t·~'~:/ ':~;f~;~i:~ .', .,. ç,. ," \'p'e' '~;..... ,/ ~e'" '<.., .~ ';)i '. .. '~': :/;: ' }:~ . :e.' , ¡ ',.. - -. -." ;>;:. .:\ > . -, ..:_~.' .. - ,'. . '" : . .~. -:"':"':." -. . ,-. . ~ .', .' - .' . -. .'- .' .,'.. . . '. "'" azardous MaterialslHâiåfd:~us:'W~iste:'U nified:·Permit.··· , " ': ,. \. .<.~:J';:;:.:..:,..<~:: ;.~::~:<::.,~.:'.;~:<~..,:,': > .'., '. .'. .,: :'..¿:' ; :: . NDITION.SOF",PERMIT~ON R.EVERSESIDE .'0 '~~..,':._~.:~ ~~;'~';:.',:' _ :-; " ~ '- ~ .' Permit ID #:: 015-000-000258 GOSFORD ANIMAL HOS LOCATION: 8040 WHITE LNB&C' I I , ¡¡ Issued by: ;,; "'~. . . ' ;- ", . ". ..... i , ' . , .~ '. , ,This . permit is Issued for the following: ItI Hazardo,usMaterials Plan . : 0 Underground Storage of Hazardous Materials ',' 0 Risk Management Program ' , ." o Hazardous Waste On-5ite·Treatment " ," I" '-,. . ~ " "~ ~ " ~ .; . .~)- .', ,'! :;".' ~;;; '$..,.: "". "": . ' ,", ,'t": ,_; _. ~,.", ,,:!" k:, '. '. .. 'r" ~ . .... " ~ '. ;.' ... . , ,..., '.;. '..... ~ \.. .,'0: " <.~' '. ' " " ; 0' , , . ,., . "- :-,' ,;. .~ ... . ' ,'- : ,.j. , , ,,~ ,.. , .' , ',c,":OAppro~edby:' " . ..... Issue Date .' .', Expiration Date: -------------~- . -·--~---1 Perna it to Operate . Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: !!tt~~ardous Materials Plan . .. . ···:~~round Storage of Hazardous Materials !·!Q,~gement Program !.. Waste 8040 WHITE PERMIT ID# 015-021.Q00258 GOSFORD ANIMAL HOSPITA .. LOCATION ,', Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 *~ ph Huey, ffice.of ental Servi es Jùne 30, 2000 I Approved by: Expiration Date: ./ H l\'M P PLA1e MAP , SITE DIAGRAM I I FACILITY DIAGRAM 1"....1><:1 Business Name: (JVs~J ~~~v-Q ~~f';tz,..-e_ Business Address: 00 t-f 0 Wk ~ k LV\" S \¡ ,- +e s' B r C / For Office Use Only First In Station: Inspection Station: Area Map II of NORTH -0 1-- -- - - -_. -- - M&tiY\ ~vrf'rM'lce ~": ~ 5 1/; +e.... C 7 /, et--\~ <1\ ~ f - " ~\ '\ /µ//^~~ ~r\()-'///\ ~/ .. t r' / ~- \ð- - -¿/- , , /\', ,- ./~'\S"~~ ' ,~~\ \J ... V \ / ~S-b c-;; ()-z TItN k: C~,^-~ì Vl f ~ ) -k .ß / SV' 07/25/00 10:39 , '8'661 326 0576 I BFD HAZ MAT DIV @001 *************************** *** ACTIVITY REPORT *** *************************** TRANSMISSION OK i TX/RX:NO. CONNECTION TEL I 6723 3971187 CONNECTION ID START!TIME USAGE:TIME PAGES' ¡ RESULT I I I 07/25 10:36 02'33 7 OK FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H· Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave, Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 July 25, 2000 Donna Hayes, Office Manager 4-Paws Pet Hospital 4201 Mexicali Drive Bakersfield, CA 93313 Dear Ms. Hayes: We received your Fax dated July 4th regarding the "Permit to Operate" that was sent to you under the previous name of Gosford Animal Hospital. We sent a computer generated printout for you to revise on June 13,2000, we have not received your reply to that notice. That notice was also a reminder that the California Health and Safety Code requires handlers of hazardous materials (in your case Oxygen) to revise their business plan within 30 days following, among other things, a change in business name and business address. Once we receive your revised business plan we will send you a corrected "Permit to Operate". Sincerely, !J Esther Duran Office of Environmental Services --y~ de W~ ~ ~0Pe.r~ Jß W~" GOSFORD ANIMAL HOSPITAL SiteID: 015-021-000258 Manager Location: 8040 WHITE LN B&C City BAKERSFIELD BusPhone: Map : 123 Grid: 16C (805) 397-3767 CommHaz : Minimal FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 09 EPA Numb: SIC Code:0742 DunnBrad: Emergency Contact / Title Emergency Contact / Title DONNA HAYES / OFFICE MANAGER MUKAND SANDHU / OWNER Business Phone: (805) 397-3767x Business Phone: (805) 397-3767x 24-Hour Phone : ( ) - x 24-Hour Phone : (805) 588-7205x Pager Phone : ( ) - x Pager Phone : (805) 637-4726x Hazmat Hazards: Fire Press ImmHlth Contact : Phone: ( ) - x MailAddr: 8040 WHITE LN B&C State: CA City : BAKERSFIELD Zip : 93309 Owner MUKAND SANDHU DVM Phone: (805) 665-9452x Address : 8201 CAMINO MEDIA State: CA City : BAKERSFIELD Zip : 93311 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: f= Hazmat Inventory f== As Designated Order One Unified List 1 All Materials at Site 1 Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP OXYGEN, , (Type or print namG) F P IH Do hereby certify that I have G 256.00 FT3 Low I 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. Signarure Date 4\s4\f -1- 07/25/2000 F GOSFORD ANIMAL HOSPITAL F Inventory Item 0001 F= COMMON NAME / CHEMICAL NAME OXYGEN SiteID: 015-021-000258 l Facility Uni~: Fixed Containers on Site l Days On Site 365 Location within this Facility Unit SURGERY ROOM Map: Grid: CAS # 7782-44-7 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 256.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 256.00 FT3 Daily Average 256.00 FT3 %Wt. RS CAS # 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low HAZARD ASSESSMENTS -2- 07/25/2000 F GaSPaRD ANIMAL HOSPITAL I F Notif. /Evacuation/Medical ¡=: Agency Notification DIAL 9-1-1. SiteID: 015-021-000258 =¡ Fast Format =¡ Overall Site =¡ 12/20/1991 ] ] 1 12/20/1991 r=:: Employee Notif./Evacuation CRBAL. I Public Notif./Evacuation VERBAL. I D'IAL Emergency Medical Plan 9-1-1. GIVE FIRST AID AT SCENE. 12/20/1991 12/20/1991 1 -3- 07/25/2000 F GOSFORD ANIMAL HOSPITAL I p= Mitigation/Prevent/Abatemt Release.Prevention SiteID: 015-021-000258 ~ Fast Format ~ Overall Site ~ 12/20/1991 COMPRESSED GAS CYLINDERS SECURED IN PLACE BY CHAINS. r=:;ARelease Containment I Clean Up N/A I I 12/20/1991 12/20/1991 ] ] I Other Resource Activation -4- 07/25/2000 F GOSFORD ANIMAL HOSPITAL I f= Site Emergency Factors r== Special Hazards Utility Shut-Offs SiteID: 015-021-000258 ì Fast Format ì Overall Site ì I ~€.~~ M\<JY\.-\ 'Ve. ~(\5ed ~ BLDG 12/20/1991 A) GAS - REAR OF BLDG B) ELECTRICAL - REAR OF C) WATER - REAR OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 11/10/1998 PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM. NEAREST FIRE HYDRANT - 150 FT S IN FRONT AND ALSO 200 FT S IN REAR. Building Occupancy Level -5- 07/25/2000 í GOSFORD ANIMAL HOSPITAL ëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 015-021-000258 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format j íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 08/29/1997 i o 0 o THERE ARE 3-5 EMPLOYEES AT THIS FACILITY DEPENDING ON THE SEASON. o o o o MSDS SHEET FOR OXYGEN IS ON FILE. o o o o BRIEF SUMMARY OF TRAINING PROGRAM: ORAL AND WRITTEN PROGRAM COVERING o WORKPLACE HAZARDS. 0 o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ 0 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf Jul 04 00 12:24p -f" -, r¡ ~ _,,~,...,.,1iO ,-, ,!&, ..' ~' ". !a-" 4- ~ 4 Paws Pet Hospital (661)397-1187 p. 1 MUKAND SANDHU, D.V.M. FAX COVER SHEET 4-PAWS PET HOSPITAL & PET SUPPLY STORE 4201 Mexicali Drive Bakersfield, CA 93313 Telephone: (661) 397-3767 FROM 4-PAWS PET HOSPITAL 4201 Mexicali Drive Bakersfield CA 93313 Formerly: Gosford Animal Hospital TO Ralph E. Huey, Director Environmental Services Administrative Services Bakersfield Fire Department TOTAL PAGES INCLUDING COVER SHEET 3 DATE 7/3/00 TIME 1:30pm FROM PHONE/FAX# 661-397-3767 / 661-397-1187 / 661-395-1349 TO PHONE/FAX# 66l-326-3941 SPECIAL NOTE Regarding name change of our hospital Jul 04 00 12:24p ~ /,'1 -??I¿ ,#...... c.<#. ". ~. .... ~. '" ~ ... ~. 4 Paws Pet Hospital (661)397-1187 p.2 MUKAND SANDHU, D.V.M. 4-PAWS PET HOSPITAL & PET SUPPLY STORE 4201 Mexicali Drive Bal<ersfield. CA 93313 Telephone: (661) 397-3767 July 3, 2000 Regarding: Address change Dear Ralph E. Huey, Director I received a certificate in the mail for a "Permit to Operate" hazardous materials. The name on the certificate is an old name of our former hospital. Please note the correct new name and address printed on our letter head. Please make corrections for your files. If you have any questions please call my office Monday through Friday 8am to 5pm at 661-397-3767. /l1'l1..? n k £Jli71.1t Donna Haye Office Man' I' (T)' ., Q... Per Ît Operil.te· ["-- CD .-t .-t I ["- en (T) .-t c.c- c.c to Hazardous Materials/Hazardous Waste -Unified Permit- CONDITIONS OF PERMIT ON' REVERSE SIDE 0- 9QL0s ~ GOSFORD ANIMAL HOSPITA This permit is issued for the following: ~ Hazardous Materials Plan o Underground Storage of Hazardous Materials , o Risk Management Program o Hazardous Waste On-Site Treatment . Permit ID #:: 015-000-000258 - LOCATION: 8040 WHITE LN B&C l\- ;20 ~ {V\ eJ} ( C G__,¡\I\ q ....... II). .¡.J' ,~ I Q... 111 , 0 'I I· I I ~ I a.. I I 111 , 3 ru a.. I 'It Q... 'It C\J .. C\J .-t Issued by: o Or.... 'It ". 0- S\ ...... ;l\ :J .., Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Approved by: JU~ 2 a lQIDJ~ Issue Date Expiration Date: June 30, 2003-· «' ~I ,:;~ :<! ,- 1 ..:J. ,. ....n~/:/-\r:·E 730 ~ ,- -~--=- n n '"') 7 -"_......J~... '..:';"-è'? : t ~- r :..I t....._ 22~~, (,~-:: , , /~ // ":- ,/ .., ",~ ç"\ ¡m III' \'\ l\ ,JUIW6'10' 01 \\ v i \ ' I ',... " ,'o .1 ~::;....'" Rr::T' "~ ' . "-, l....'I\N SEP' (I .~ Rc:nu~ ,\\,¡Ct::. o~ '--_~ ¡-c;-rr-o ,,-,oJ _ , _,,"-,, C f-<J: t,u í:" h'- rr:~J _, ,\Iv;"-Rj('" ' aÜ E' " '/ _.. ,,- ,,·~~!'·,N C ¡'V (1)"- ¡,.-'",.:..';:'.::.';'" '.' W01 ,,'-', ,cL,D r \ «:::; ; ,-","'\ (1." ">x~ .. ~O.µ~ v--' _._~J . oJ . ~ouiR-~ ~~/< ~,J¡.' ~ J!'" \0 \ ~~ANCEDEPARTMENT CITY OF BAKERSFIELD P.O, BOX 2057 BAKERSFIELD, CALIFORNIA 93303 RETURN SERVICE REQUESTED 06/iO/00 06 GOSFO~O 933092032 1C99 RETURN TO SENDER :GOSFORD ANIMAL HOSPITAL ~20i ME,XICALI DR 8AKERSFIELD CA 93313-2025 -- --___......L_ I II I I I " I.Iq'l' --- -~ , I I I,ndl,-" , ) Aifns, 98889 ~3~Q~-'ZQ51 '\ \ ~ i'j e GOSFORD ANIMAL HOSPITAL Manager .' Location: 8040 WHITE LN B&C City BAKERSFIELD / ~ B¥:' ~. BAKERSFIELD STATION 09 Emer enc Contact Title IY.l.L1'HJ;!;LL:f¡ Li'NAM· / OFFI~~GER uSJ.ness one: (805) 39~37{P 7 24-Hour Phone ( ) - x Pager Phone () x Hazmat Hazards: Contact : MailAddr: 8040 WHITE LN B&C City BAKERSFIELD Owner Address City MUKAND SANDHU DVM 8201 CAMINO MEDIA BAKERSFIELD Period Preparer: Certif'd: to Emergency Directives: f= Hazmat Inventory p== As Designated Order e NOV /'-- (805) 397-3767 CommHaz : Minimal FacUnits: 1 AOV: SiteID: 215-000-000258 9 19i&sp Map Grid one: 123 16C SIC Code:0742 DunnBrad: Emergency Contact MUKAND SANDHU Business Phone: 24-Hour Phone Pager Phone / Title / OWNER (805) 397-3767x (805) 588-7205x (805) 637-4726x Fire Press ImmHlth Phone: ( x State: CA Zip 93309 Phone: (805) 665-9452x State: CA Zip\ : 93311 TotalASTs: = Gal TotalUSTs: Gal RSs: No One Unified List 1 All Materials at Site 1 Hazmat Common Name... bailyMax SpecHaz EPA Hazards MCP OXYGEN F P IH UI /)DAll\lA II J:1. Y f.5 100 hsreby c®91i~ ~ha~ ~ tl'Bav® i'fY~1IW fj~~ i"~'1iSWSd ~h1s ~~hoo hazardous matîeuiêlls manage- GDSFD R- P m~i1~ plêln ~or AAl/m ilL ¡.J{)sP. amd ~ha? i~ along with (ëijatM of Gaœ) any ooi'rOOiåOrls oonstô~13i~ .g¡ compleie and corr@ci man- agement [OI2n ~Oi' mv ~mÍ1? I . / I -~ 8 ---Cj<j Date . -1- G 256 FT3 Low 10/27/1998 '. - e F GOSFORD ANIMAL HOSPITAL p= Inventory Item 0001 = COMMON NAME / CHEMI CAL NAME OXYGEN SiteID: 215-000-000258 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit SURGERY ROOM Map: Grid: CAS # 7782-44-7 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS~ CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 256.00 FT3 Daily Average 256.00 FT3 HAZ US ENT %Wt. RS CAS # 100.00 Oxygen, Compressed No 7782447 ARDO COMPON S HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low -2- 10/27/1998 .. e SiteID: 215-000-000258 ì Fast Format ì Overall Site ì 12/20/1991 ] 12/20/1991 1 12/20/1991 1 12/20/1991 e F GOSFORD ANIMAL HOSPITAL I f= Notif./Evacuation/Medical ~I::e:::_:~tification ~ .Employee Notif./Evacuation CRBAL. - Public Notif./Evacuation VERBAL. Emergency Medical Plan DIAL 9-1-1. GIVE FIRST AID AT SCENE. -3- 10/27/1998 .. e e F GOSFORD ANIMAL HOSPITAL I f= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-000258 ì Fast Format ì Overall Site ì 12/20/1991 COMPRESSED GAS CYLINDERS SECURED IN PLACE BY CHAINS. r=:;ARelease Containment [ N/A Clean Up I 12/20/1991 12/20/1991 1 ] I Other Resource Activation -4- 10/27/1998 " e e F GOSFORD ANIMAL HOSPITAL I p= Site Emergency Factors r== Special Hazards Utility Shut-Offs SiteID: 215-000-000258 l Fast Format l Overall Site l I 12/20/1991 A) GAS - REAR OF BLDG B) ELECTRICAL - REAR OF BLDG C) WATER - REAR OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 12/20/1991 PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM. NEAREST FIRE HYDRANT - 150 FT SOUTH IN FRONT AND ALSO 200 FT SOUTH IN REAR. Building Occupancy Level -5- 10/27/1998 " '" e e í GOSFORD ANIMAL HOSPITAL ëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000258 íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 08/29/1997 ¡ o 0 o THERE ARE 3-5 EMPLOYEES AT THIS FACILITY DEPENDING ON THE SEASON. o o o o o MSDSSHEET FOR OXYGEN IS ON FILE. o o o BRIEF SUMMARY OF TRAINING PROGRAM: ORAL AND WRITTEN PROGRAM COVERING o WORKPLACE HAZARDS. o o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ 0 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj ¡..- - - -,~ GOSFORD ANIMAL . 0 lE~~-~-~ HOSPITAL ) lJ: AUG 29 1997 ! '~\ I BusPhone: B&&ï~ _~, ___~" ~~ld~ i~~ e SiteID: 215-000-000258 Manager Location: 8040 WHITE LN City BAKERSFIELD (805) 397-3767 CommHaz : Minimal FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 09 EPA Numb: SIC Code:0742 DunnBrad: Emergency Contact / Title Emergency Contact / Title MI CHELLE LYNAM / OFFICE MANAGER MUKAND SANDHU / OWNER Business Phone: (805) 397-3967x Business Phone: (805) 397-3767x 24-Hour Phone : ( ) - x 24-Hour Phone : (805) 588-7205x Pager Phone : ( ) - x Pager Phone : ,("6" 6.> ) 63 7 - '17r76x Hazmat Hazards: Fire Press ImmHlth Agency-Defined Topic Title I One Unified List 1 All Materials at Site 1 p= Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP OXYGEN F P IH G 256 FT3 Low - - - - <-- !, ~ ì ,.l.p.lle . L\J n Q W\.Do hereby carmy ihæ ~ hav$ ~v¡ttJ or pnnt r.ijfi~) reviewød the ati.achod h~amQu$ msierials manage- . ~ '~ 1b.sp,N!-'I-J . . fA merÜ pian for~.D'¡~f.d i'\/ =, ~ ihât Ii along Wit" '\F-~ ( jõ nQðO any correc~ions constiiu~~ ~ oom~i~~ ~nd colTed man- agi3ment plan f@f' my ~ij¡~. ~~ tJ~-/þz.~ ?- ;;;:¡~?7 -1- 08/14/1997 --- ~ e e F GOSFORD ANIMAL HOSPITAL I p= Notif./Evacuation/Medical ¡=:I::e:::_:~tification ~ ~loyee Notif./Evacuation CRBAL. I Public Notif./Evacuation VERBAL. SiteID: 215-000-000258 =¡ Fast Format =¡ Overall Site =¡ 12/20/1991 1 1 ] 12/20/1991 12/20/1991 Emergency Medical Plan 12/20/1991 DIAL 9-1-1. GIVE FIRST AID AT SCENE. -2- 08/14/1997 ¡.... Ii e e F GOSFORD ANIMAL HOSPITAL I p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-000258 1 Fast Format 1 Overall Site 1 12/20/1991 COMPRESSED GAS CYLINDERS SECURED IN PLACE BY CHAINS. ~ARelease Containment I Clean Up N/A I 12/20/1991 12/20/1991 ] ] I Other Resource Activation -3- 08/14/1997 ....... " ... ..-:w< e e F GOSFORD ANIMAL HOSPITAL I p= Site Emergency Factors ~ Special Hazards Utility Shut-Offs SiteID: 215-000-000258 l Fast Format =¡ Overall Site =¡ I 12/20/1991 A) GAS - REAR OF BLDG B) ELECTRICAL - REAR OF BLDG C) WATER - REAR OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 12/20/1991 PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM. NEAREST FIRE HYDRANT - 150 FT SOUTH IN FRONT AND ALSO 200 FT SOUTH IN REAR. Building Occupancy Level J -4- 08/14/1997 .,- (' f"., .IÞ - F GOSFORD ANIMAL HOSPITAL I F Training I Employee Training SiteID: 215-000-000258 ì Fast Format ì Overall Site ì 09/02/1994 3-S- J2..fY''f)loý~e5 defend/Y\J 0 5e CL ,>ot\. . THERE ARE THREE EMPLOYEES AT THIS FACILITY. MSDS SHEET FOR OXYGEN IS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ORAL AND WRITTEN PROGRAM COVERING WORKPLACE HAZARDS. Page 2 [ I I Held for Future Use Held for Future Use >- .' -- ---......... ---- ---- ----- ----- ~--":- ----- ~--- __=-__.._"'- _ ~~ __~_________.....~____ 0_ -5- 08/14/1997 A~ 7;)c;¡ 01 General Information ~~CG~DW~~ 215-000-000251 PëQ Fac. Unit SEP 1 1994 D CJ - - ,/', ~- ~~ --- Jf . ~ 08/26/94 ---- GOSFORD ANIMAL HOSPITAL Overall Site with 1 1 Bv Location: 8040 WHITE LN B&C City : Map:123 Haz:1 Type: 3 Grid: 16C FlU: 1 AOV: 0.0 --- Contact Name Title ANNA PAe£Co\')t\ì(... Pu.Uctrl WIYE ~fYIa"IQ~í Bus i nes s Phone: ( 805 ) 2f'tî - $lfcî x 24-Hour Phone: (805) aJ1 J1~Jx Pager Phone : ( ) - x ~ Contact Name Title BA~y~ID PACE f\\lÙ.ð.Y\Ò S:t.rd~OWNER Business Phone: (805) 397-3767x 24-Hour Phone: (805) ~31 316Jx~-q4~l Pager Phone : (ß05) lP33 -loœbx Mail Addrs: City: L Comm Code: (¡ / ~J r'Ù ~Owner: Address: City: Administrative Data 8040 WHITE LN B&C BAKERSFIELD 215-009 BAKERSFIELD STATION 09 D&B Number: State: CA Zip: 93309- SIC Code: 0742 lllprIR h FACEI DVM Y)\..Ù_LtX,d Sol"'\dhu D\)'I'Y\ 9 H~ 9 MEABmfLEAP' CT <zfZO\ Cel'CY\ì no me.d \~ BAKERSFIELD ~ '-' ~...., ""ft) .. Phone: (805) uu-z uu..JJ State: CA Zip: 93311- Summary . n \\^.r Do hereby certify that , have , CÖY\ \'\ ,c.., y \.,L ~L t (Type or print name) h ttached hazardous materials mar.age- reviewed tea ., f b::e,Çi:>ìd ~~ and that it atong with ment Pian or '~'\ (Name 0 Cß~ \'I v.. any corrections constitute a complete and correct man- agement plan for my faCility. ~.J~11OL: .~ .. . 'e 08/26/94 GOSFORD ANIMAL HOSPITAL 215-000-000258 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 256 Low FT3 02-001 OXYGEN ~ Fire, Pressure, Immed HIth Gas '0 -- e 08/26/94 GOSFORD ANIMAL HOSPITAL 215-000-000258 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-001 OXYGEN ~ Fire, Pressure, Imrned Hlth Gas 256 Low FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: ANESTHETIC Daily Max FT3 ----r-- Daily Average FT3 --r-- Annual Amount FT3 -- 256 I 256.00 I 1,000.00 Storage r Press T Temp ~ PORT. PRESS. CYLINDER Above Ambient I SURGERY ROOM Location - Conc l 100.0% Oxygen, Compressed Components ~ MCP --rGuide Low I 14 ~ - e 08/26/94 GOSFORD ANIMAL HOSPITAL 215-000-000258 00 - Overall Site Page 4 <D> Notif./Evacuation/Medical <1> Agency Notification DIAL 9-1-1. <2> Employee Notif./Evacuation VERBAL. <3> Public Notif./Evacuation VERBAL. <4> Emergency Medical Plan DIAL 9-1-1. GIVE FIRST AID AT SCENE. '. ~, . e 08/26/94 GOSFORD ANIMAL HOSPITAL 215-000-000258 00 - Overall Site Page 5 <E> Mitigation/Prevent/Abatemt <1> Release Prevention COMPRESSED GAS CYLINDERS SECURED IN PLACE BY CHAINS. <2> Release Containment N/A <3> Clean Up N/A <4> Other Resource Activation ~ - e 08/26/94 GOSFORD ANIMAL HOSPITAL 215-000-000258 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - REAR OF BLDG B) ELECTRICAL - REAR OF BLDG C) WATER - REAR OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM. NEAREST FIRE HYDRANT - 150 FT SOUTH IN FRONT AND ALSO 200 FT SOUTH IN REAR. <4> Building Occupancy Level j' ,'~'" e e 08/26/94 GOSFORD ANIMAL HOSPITAL 215-000-000258 00 - Overall Site <G> Training Page 7 <1> Page 1 ctrQ..- ~Qe... THERE rs OnLY ONE EMPLOYEESAT THIS FACILITY. MSDS SHEET FOR OXYGEN IS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ORAL AND WRITTEN PROGRAM COVERING WORKPLACE HAZARDS. <2> Page 2 as needed <3> Held for Future Use I <4> Held for Future Use e General Information age 1 + t-:.... ...-" .\~. 07/2-919~ GOSFORD ANIMAL HOSPITAL Overall Site with 1 Location: 8040 WHITE LN B&C Community: BAKERSFIELD STATION 09 Map: 123 Hazard: Minimal Grid: 16C FlU: 1 AOV: 0.0 Contact Name ANNA PACE DAVID PACE Title Business Phone (805) x (805) 397-3767 x 24-Hour Phone (805) 831-3763 (805) 831-3763 WIFE OWNER Administrative Data Mail Addrs: 8040 WHITE LN B&C City: BAKERSFIELD Comm Code: 215-009 BAKERSFIELD STATION 09 D&B Number: State: CA Zip: 93309- SIC Code: 0742 -Owner: DAVID A PACE' DVM Address: ;j161 NORTHWINIJ D~ 0/1{ ocr ~~a P. Cf. City: BAKERSFIELD Phone: (805) 9J1 J761- State: CA ~6¿¡-of:Js:. Zip: 93313 q3~11 Summary I, De( \I ì-) A, Pa ce Do hereby csrtiiy that I have (Type or print name) reviewed the attached hazardous materials manage- meni pi~B"! ~©&~J~~ ~;¡'nd tha~ ii' álong wåRh (Name ol.,,"'S"lf>~» any OOIT®~¡@~S constituts ~ complets and correct man- ' agement plan for my facility. ~~ ritJ .~~ ,; e e ~ 07l29/9'~ .. GOSFORD ANIMAL HOSPITAL 215-000-000258 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 OXYGEN .~ Fire, Pressure, Immed Hlth Gas 256 Low FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: . Pure Days: 365 USé: ANESTHETIC Daily Max FT3 ----r-- Daily Average FT3 --r-- Annual Amount FT3 -- 256 I 256.00 I 1,000.00 Sto~age . r Press T Temp ~ PORT. PRESS. CYLINDER Above Ambient I SURGERY ROOM Location . - Conc l 100.0% Oxygen, Compressed . Components - r:- MCP --rList Low I ~ ~ e e .. 07/29/92 . GOSFORD ANIMAL HOSPITAL 2l5-QOO~000258 00 - Overall Site Page 3 <D> Notif./Evacuation/Medica1 i <i> Agency Notification DIAL 9-1-1. <2> Employee Notif./Evacuation VERBAL. <3> Public Notif./Evacuation VERBAL. <4> Emergency Medical Plan DIAL 9-1-1. GIVE FIRST AID AT SCENE. e e '.:..'~ & .. ,07129/g}. GOSFORD ANIMAL HOSPITAL 215-000-000258 00 - Overall Site Page 4 I <E> Mitigation/Prevent/Abatemt <1> Release Prevention COMPRESSED GAS CYLINDERS SECURED IN PLACE BY CHAINS. <2>'Release Containment N/A <3> Clean Up N/A <4> Other Resource Act~vation I I. e e \4" ~ c' ~ 07/29/9-'2 GOSFORD ANIMAL HOSPITAL 215-000-000258 00 - Overall Site Page 5 <F> Site Emergency Factors I < 1> Special Hazards , <2> Utility Shut-Offs A) GAS - REAR OF BLDG B) ELECTRICAL - REAR OF BLDG C) WATER - REAR OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM. - NEAREST FIRE HYDRANT - 150 FT SOUTH IN FRONT AND ALSO 200 FT SOUTH IN REAR. I <4> Building Occupancy Level e e :.. '''.1~' ~. 07l29/9~ GOSFORD ANIMAL HOSPITAL 215-000-000258 00 - Overall Site Page 6 <G> Training <1> Page 1 THERE IS ONLY ONE EMPLOYEE AT THIS FACILITY. MSDS SHEET FOR OXYGEN IS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ORAL AND WRITTEN PROGRAM COVERING WORKPLACE HAZARDS. <2> Page 2 as needed <3> Held for Future Use / I <4> Held for Future Use "'. l' f( ,e 'e of--· Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 RECEIVED lDEC 1 6 199' L. '1 ~5 /} 0 \ HAZARDOUS MATERI ANAGEMENT PLAN 1\'J-'jí r~ ~ Hit? MAT.OIV. 1. 2. 3. 4. To avoid further action, return thl TYPE/PRINT ANSWERS IN ENGLISH. Answer the questions below for the business as a whole. Be brief and concise as possible. t INSTRUCTIONS: I ¢.3-IIoL cr'~ q ß SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: ~ S FORÞ . Æ-N' M k-L t+-o 0 P I "( A L- LOCATION: 8'04D w~;k Lat'LP) ÇU\'{-eS ßt- C MAILING ADDRESS: ~LlD wl/t(~k. ~, 5" v~ k- ß , , CITy:ßcd<eí5f'\e(~ STATE:cA ZIP~ 3 301 PHONE: "397-37b7 DUN & BRADSTREET NUMBER: SIC CODE: PRIMARY ACTIVITY: V e.+ev ~ '^ a.v 7 fh, s p .'~ OWNER: DVlV~d A-, ?ac-e v.V.M. J MAILING ADDRESS: ß 10\ tJOyt-~w~ ^J D V".: Bttkø-rs~'dJ., cA C,33'3 , SECTION 2: EMERGENCY NOTIFICATION: CONTACT 1. AV\Vt~ ?ác-e 2. ])o..vìtl ? ({c,e TITLE w~k BUS, PHONE 24 HR, PHONE ~3\-3/~3 ~'3( -37~3 Ow Y\ e-r '3,ci7- '37 (;, 7 1 , FD1590 _ Bakersfield Fire· Dept. e . Hazardous Materials Division , ,.... ~ HAZARDOUS MATERIALS MANAGEMENT PLAN ;. \ ,~..;-. , ('~!':.~- ;.~->c:.~ r;:~:~':'; ,.SECTION.3: TRAINING: . ;;, ~. " ~ ~ .. . .' .virNUMBE'R·:'0F EMPLOYEES: () VI e... / ' MATERIAL SAFETY DATA SHEETS ON FILE: ) 0 VI e. ~RIEF SUMMARY OF TRAINING PROGRAM: 0 r~ ~tß V<ff)' ~ f>nJó Ira.-- ~ . , ~'\... " I ~ P LfÞCE'. ~tl -Z tVt d.5 . GÖ v'~ v'\.j vv (.J '( vc:- --~- -~--- ---""'..-.,.."......~---~, ,-- -_.-. -- - -- ~~ .........,-......,.... - -~"--~~ ~-- -- - SECTION 4: EXEMPTION REQUEST: ·1 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 TlMEE~CE~D THE MlWMUr'vLHfE9RTIN~ QU~~T!TIES~ ___ ,__~___~_ OTHER (SPECIFY REASON) - -,----- -. -0----.". ~ ~_ _ -=. , SECTION 5: CERTIFICATION: I; bO\~\J A. ra.c-ë¡ j)~V,M CERTIFYTHATTHEABOVEINFOR- . MATlON IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALlFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC, 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. .~ U~ ~ ()WYle-V SIGNATURE 'TITLE ¡')-(/-Ql DATE 2. FD1590 £'- ,":;t -. ~ _ Bakersfield Fire Dept.. Hazardous Materials Division / / '~I HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: h-v swJ ~Ì'vVlv-Q ~ s P}~'f-o-(?_ SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: b (' ~ g ( { I I . !. I I B. ! EMPLOYEE NOTIFICATION AND EVACUATION: 'V ~ k7~ C: PUBLIC EVACUATION: V~b~ D. EMERGENCY MEDICAL PLAN: bÌ'0-<2- ~\¡-e ~Ì"f5+ kJ q { { d S~ 3. FDl&;Q . Bakers,field Fire Dept. e Hazardous Materials Division ~~ <, '" , ~'\" )" . '1:}" HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A, RELEASE PREVENTION STEPS: ~d 6-CLd C; {(Vtb-5 ~j ~ ft~ (¿, ì C~cv1 ý\ s B. RELEASE CONTAINMENT AND/OR MINIMIZATION: " -- --..."...-~-_.~. ---<._".-....,-~~-~-~----=-- ;.. -,-~ ,- -, -,...,..---,-----.-:-:- -....,.=---,,~--- - -~- -- -- - - - /VI A C, CLEAN-UP PROCEDURES: (V! A- SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: ~'O/Ý c>f . B l/ ~l cti''V\. J ELECTRICAL: ~cvr-' () {- 13(/\ cÆ;Y'\.- 5 ~. _~ ___~ ,WáIER: dZeow- 0 ~ ß3 lr " I J. ,Yl 5 SPECIAL: LOCK BOX: YES/r@ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A, PRIVATE FIRE PROTECTION: <SfV': ,/'\ k (8y 5''1 5 -I-e ~ " B. WATER AVAILABILITY (FIRE HYDRANT): {50 Sout'lA.. (V) ~ ::J-Ol) ~+ 5õvtk ~ ~ Re~ 4. FD1590 c: I ..-.I....y. BAKER.SFIELD HAZARDOUS, MATERIALS INVENTORY OF" - ~ " NON - TRADE SECRET J "-~- Ä.;"".·, ..~ :...fI'), .r,/ page·'Q! -r'_ o Farm and Agriculture 0 Standard Business "i:" 1 Trans Code AJ OWNER NAME: 1:>4v lOA- - PA Cé"' ADDRESS: SOLIe.:> wh.ì~ £-"" :::fr~ CITY, ZIP: '&.k~'S-(;-~ CA or ~30 9 PHONE I: fÇoç .Jq,77b I 8"'3/-'3'(.,,3 . INSTRUCTIONS FOR PROPER CODES 9 10 11 12 Cont Cont Use Location Where Press Temp Code Stored in Facility ii '5ur<~'( ROO ',..., BUSINESS NAME:6-0.$R>RD A-N'iM,+<- tfv5Plì.4L. LOCATION: 8fLf 0 W Î'\;f-~ LvI, J S v:+-e R..;- C. CITY, ZIP: c..ker~-{1i~(d C..A c(~3.0C\ PHONE #: (~Q~) ',3.0::;7- ~'~7 , NAME OF THIS FACILITY: STANDARD IND. CLASS CODE: DUN AND BRADSTREET-NUMBER/FEDERAL ID t - - -- 13 " by wt . . Physical and Health Hazard C.A.S. Number Component 1# 1 Name , C.A.S. Number (Check all that apply) ~e Hazard ~sudden Release o Reactivity 0 0 Component 1# 2 Name , C.A.S. Number Immediate Delayed of Pressure Health Health Component 1# 3 Name , C.A.S. Number , ,. Physical and Health Hazard C.A.S. Number Component 1# 1 Name , C.A.S. Number (Check all that apply) / 0 0 p 0 o Delayed Component 1# 2 Name , C.A.S. Number Fire Hazard Sudden Release Reactivity Immediate of Pressure Health Health Component 1# 3 Name , C.A.S. Number Physical and Health Hazard (Check all that apply) CI Fire Hazard 0 Sudden Release 0 Reactivity 0 Immediate 0 Delayed of Pressure Health Health C.A.S. Number C~mponent 1# 1 Name , C.A.S. Number Component 1# 2 Name , C.A.S. Number , Component 1# 3 Name , C.A.S. Number I, Physical and Health Hazard (Check all that apply) I: 0 Fire Hazard 0 C.A.S. Numbèr Name Title Component 1# 1 Name , C.A.S. Number Componsn): 1# 2 Name , C.A.S. Number Component 1# 3 Name , C.A.S. Number 12 24 Hr. Phone Name Title 24 Hr Phone Sudden Release 0 Reactivity Cl Immediate 0 Delayed of Pressure Health Health i'/ EMERGENCY CONTACTS I Certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) Icertify under peanlty of law that I haver personally BKamined and am familiar with the information submitted in this and all attached documents and that based on my inquiry of those I individuals responsible for obtaining the information. I believe that the SUbmitted, information is true, accurate, and complete. #1 : NAME AND OFFICIAL TITLE OF owNER/OPERATOR OR OWNBR/OPBRATOR'S AUTHORIZED REPRESENTATIVE SIGNATURE DATE SIGNED