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HomeMy WebLinkAboutBUSINESS PLAN I \ ! n I'~ I -,- """I I "OEL B. NAPOLE-S-ll:;~c . 1: I. 3 -,-,v. II 81..0 WIBLE ROADE SU-~'~'I-: "c II ~- L" 11 ~ ~ ~r ,> .::j" (5 313 ~O Manager Locati City SANDY NAPOLES 3820 WIBLE RD C BAKERSFIELD BusPhone: Map : 123 Grid: 14B SiteID: 015-021-a02309 (661) 832-~ CommHaz : Minimal FacUni 1 AOV: NAPOLES DDS JOEL B SIC Code:8021 DunnBrad: CommCode: EPA Numb: Emergency Contact JOEL B NAPOLES DDS Business Phone: (66 24-Hour Phone ( Pager Phone ( Title OWNER 832-4774x x x / Title / Phone: ) x Phone ) x Phone ) x React Phone: (661) 832-4774x State: CA Zip 93309 Phone: (661) 832-4774x State: CA Zip 93309 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Hazmat Hazards: Contact : JOEL B NAPOLES MailAddr: 3820 WIBLE RD C City BAKERSFIELD Owner Address City JOEL B NAPOLES 3820 WIBLE RD C BAKERSFIELD Period Preparer: Certif'd: ParcelNo: to Emergency Directives: ~~ jof ..1~~ ~~. ~ ~~ ~ \ -1- 08/31/2007 4. SiteID: 015-021-002309 9 By Facility Unit 9 Fixed Containers at Site 9 IspecHaz'EPA Hazards' Frm , Dai1yMax IUnitlMCP R L 5.00 GAL Min F NAPOLES DDS JOEL B p= Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name... WASTE FIXER -2- 08/31/2007 .;;; -3- 08/31/2007 --. SiteID: 015-021-002309 9 Facility Unit: Fixed Containers at Site 1 F NAPOLES DDS JOEL B p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit X-RAY RM 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#7440224I A E TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min HAZARD SS SSMENTS -4- 08/31/2007 " SiteID: 015-021-002309 "I Fast Format "I Overall Site "I F NAPOLES DDS JOEL B I p= Notif./Evacuation/Medical Agency Notification Employee Notif./Evacuation Public Notif./Evacuation Emergency Medical Plan 02/27/2007 GO TO NEAREST HOSPITAL OR CALL 911. -5- 08/31/2007 j, SiteID: 015-021-002309 9 Fast Format 9 Overall Site 9 F NAPOLES DDS JOEL B I f= Mitigation/Prevent/Abatemt Release Prevention Release Containment 02/27/2007 WASTE IS AUTOMATICALLY RELEASED INTO LARGE HAZ WASTE CONTAINER WHICH SITS INSIDE A TUB IN CASE OF A SPILL. Clean Up 02/27/2007 CALL X-RAY SOLUTION SERVICE INC, 4700 EASTON DR 45, 637-0404. Other Resource Activation -6- 08/31/2007 ." SiteID: 015-021-002309 , Fast Format , Overall Site '9 F NAPOLES DDS JOEL B I p= Site Emergency Factors Special Hazards Utility Shut-Offs ELECTRIC - WALL INSIDE BLDG IN OPERATORY 1 (FIRST ROOM TO RIGHT) WATER - FRONT OF SUITE A OF OUR BLDG 02/27/2007 Fire Protec./Avail. Water 02/27/2007 FIRE EXTINGUISHERS. FIRE HYDRANT - ACROSS ST. Building Occupancy Level 02/27/2007 3 EMPLOYEES -7- 08/31/2007 .... . - <:., SiteID: 015-021-002309 9 Fast Format "1 Overall Site "1 02/27/2007 F NAPOLES DDS JOEL B I F Training Employee Training BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES TOLD TO CHECK HAZ MAT LEVEL WHEN CLEANING X-RAY PROCESSOR. ONCE CONTAINER IS THREE-FOURTHS FULL, THEY ARE TO CALL X-RAY SOLUTION SERVICE INC 637-0404. Page 2 Held for Future Use Held for Future Use -8- 08/31/2007 .f' F NAPOLES DDS JOEL B F Full Format I SiteID: 015-021-002309 , Type+Category+Sub-Category+Date2(ASC) Order 9 One Unified List 1 BUSINESS PLAN PROGRAM COMBINED PROGRAM INSPECTION Reference Dates Summary Description PERKINS 03/20/2007 OK HAZARDOUS WASTE GENERATOR ROUTINE INSPECTION Reference Dates Summary Description WINES 11/13/2001 WASTE FIXER PROVIDE SECONDARY CONTAINMENT HAZARDOUS WASTE GENERATOR COMBINED PROGRAM INSPECTION Reference Dates Summary Description PERKINS 03/20/2007 WASTE FIXER INSPECTIONS -9- 08/31/2007 ~":'~------': \0 ,," \_, \\" " --. ,,-'\' r ç'-',', J, " ' <.~ >~d ~ JOEL B. NAPOLES, D.D.S. Complete Family Dentistry 3820 Wible Road, Suite C Bakersfield, CA 93309 Telephone: (661) 832-4774 ~ .~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME :30 ~ (.. N A:>fo l...€. S DDS INSPECTION DATE --2 )~o/ t::J) / Section 4: Hazardous Waste Generator Program EPA ID # 2 X. tz..M.-f--r o Routine a Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Hazardous waste detennination has been made -........ J EP A ill Number <E.-XSMfT Authorized for waste treatment and/or storage .s. ).,.o.rb --h,,-.-"""" .J ------ Reported release, fire, or explosion within 15 days of occurrence .---. Established or maintains a contingency plan and training ............ oJ Hazardous waste accumulation time frames - ~ Containers in good condition and not leaking '-3 , 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 SO feet from property line ,JIA Secondary containment provided -"""f..i Conducts daily inspection of tanks --....... ~ Used oil not contaminated with other hazardous waste "';)j\ . Proper management of lead acid batteries including labels ,.;!t. Proper management of used oil filters IV /1\ ~ .- ...."" Transports hazardous waste with completed manifest ~ j Sends manifest copies to DTSC I { Retains manifests for 3 years ~ Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Detennines if waste is restricted from land disposal C=Comphance V=VlOlation Inspector: &il.I<-l~ Office of Environmental Services (661) 3 6-3979 White - Env. Svcs. ~ Business Site Responsible Party Pink - Business Copy G ." "; - NAPOLES DDS JOEL B SiteID: 015-021-002309 Manager Location: City Sri\J\ -N~o~ts 3820 WIBLE ~ C BAKERSFIELD BusPhone: Map : 123 Grid: 14B (661) 832-4774 CommHaz : Minimal FacUnits: 1 AOV: CommCode: BFD STA 07 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / _ Ti tIe JOEL B NAPOLES DDS / 0 vvnw-- Business Phone: (661) 832-4774x 24-Hour Phone () x Pager Phone () x )Emergency Contact Business Phone: 24-Hour Phone Pager Phone / / ) ) ) x x x Title Hazmat Hazards: React Period Preparer: Certif'd: ParcelNo: to Phone: (661) 832-4774x State: CA Zip 93309 Phone: (661) 832-4774x State: CA Zip 93309 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Contact : JOEL B NAPOLES MailAddr: 3820 WIBLE RD C City BAKERSFIELD Owner Address City JOEL B NAPOLES 3820 WIBLE RD C BAKERSFIELD Emergency Directives: PROG H - HAZ WASTE GEN Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate . nd co ete. tNi'D rEe 26 Z007 2-lrAJl-- Date -1- 02/05/2007 r>:.' SiteID: 015-021-002309 9 By Facility Unit 9 Fixed Containers at site 9 F NAPOLES DDS JOEL B f= Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP WASTE FIXER R L 5.00 GAL Min -2- 02/05/2007 t': -3- 02/05/2007 <'- ,,,. F NAPOLES DDS JOEL B p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME WASTE FIXER SiteID: 015-021-002309 , Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit X-RAY RM 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#7440224I HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / I Min -4- 02/05/2007 ~ SiteID: 015-021-002309 9 Fast Format 9 Overall Site 9 F NAPOLES DDS JOEL B I F Notif./Evacuation/Medical Agericy-N'oFi.iicatlon i ~/~ Employee Notif./Evacuation ~ " :i(ub1ic Notif."jEvacliation yv {J. " f!w -/tJ r1ft(e51 hup/fnllY MIll q If. -5- 02/05/2007 ~ F NAPOLES DDS JOEL B I . f= Mi~igation/Prevent/Abatemt Release Prevention '-.. --. - SiteID: 015-021-002309 "I Fast Format "I ' Overall Site "I ~ :$.elease . Containment / /l.J45k I~ ~m/!lic~!Ij nJDrQt( l",zrlo IR/:~Wt~f /))a~mrrlzdntr tUhiCh $;+5 lof/ok ?l' fob /11 CASe of ant{ -:pI/IIl!f' . Cl_~~n Up {)d{/! J(~ sv/u-lim Swvice, !aG <f 7 DO [j{ 5fm l/: ~45- f!;xt/!ib(1Mld/ f!A- tj ~ '(p{; 1- IP87-oLftJ't' .- Other Resource Activation -6- 02/05/2007 ;~ F NAPOLES DDS JOEL B I p= Site Emergency Factors / Special Hazards SiteID: 015-021-002309 "I Fast Format "I Overall Site "I /' / . . . =;ytility SJ:1ut--Offs \ -. tJreal&f bJy /lJlJtId (}f) ~II Ins/de Wtkit1!J ly/ opeAa-/-lf,:,tl'{ (h(~ rwn ~ rt~hf). wa4<< :jAvf-aff bo;r !oclf.WiVl [iba+ ~ sv/k~A &f rJUY I::utldfi!J' F~re Pr6tec./Avail. Water J . [2-) 72~ m-,~(ji5W'5 '(]bvlld/~~ ' . (2) tf(f- h'1dar1b ftWIS$ s-fraf'fn>rY1 (1/J( Wf !df01' Building pccup:a:Ilcy Level /' 'TIi~ -7- 02/05/2007 n . / / / ,/ :~. ~ F NAPO~ES DDS JOEL B I / F Training / ! /iEmp19yee Training/ SiteID: 015-021-002309 9 Fast Format 9 Overall Site 9 / Gnpl~f, -fr;ltJ f; ~ hiiua!IJl/SfY/tl!<<itl/ Iet/d whu/ dtAm1J Y-(Zo/ frOrLSS1JY.' &i1eL-.1 C/J//1-a inv is 0/4 R;r I -fluq au -k 6d II : . ,~ IX ~rP1 $iJ /u/i()f/ W vi Cl, I r1C . f#{f (- ttf37- 040 1 = Page 2 Held for Future Use Held for Future Use -8- 02/05/2007 l' ~I + NAPOLES DDS JOEL B ==================~=============== SiteID: 015-021-002309 + Manager Location: 3820 WIBLE RD C City BAKERSFIELD BusPhone: Map : 123 Grid: 12C (661) 832-4774 CommHaz : Minimal FacUnits: 1 AOV: CommCode: BFD STA 07 SIC Code:8021 EPA Numb: DunnBrad: +==============================================================================+ +=======================================+======================================+ Emergency Contact / Title Emergency Contact / Title JOEL B NAPOLES DDS I / Business Phone: (661) 832-4774x Business Phone:) x 24-Hour Phone : () x 24-Hour Phone :) x Pager Phone () x Pager Phone ) x +---------------------------------------+--------------------------------------+ I HazmatHazards:' ~-- -- - ~-- -=-'--8~- -- __C'._' -.--ReaGt-- -----=----.:-; .- . II +-----------------~------------------------------------------------------------+ Contact : JOEL B NAPOLES Phone: (661) 832-4774x MailAddr: .3820 WIBLE RD C State: CA City : BAKERSFIELD Zip : 93309 +-~----------------------------------------------------------------------------+ Owner JOEL B NAPOLES Phone: (661) 832-4774x Address : 3820 WIBLE RD C State: CA City : BAKERSFIELD Zip : 93309 +------------------------------------------------------------------------------+ Period to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No parcelNo: +------------------------------------lh----------------------------------------+ Emergency Directives: } I'-Il)/\t{ V PROG H - HAZ WASTE GEN '0 1 ENi'O JUL 25 2005 -- __-,,~ c-~ __ -" ... t-JlOl4-. ~ 7 t);Dl - Based .on my inquiry of those individuals responsible for obtaining the information, I certify unde~ penalty of law that I have personally exam~ned and am familiar with the information submitted and believe the information is true accurate, and complete. ' ~ t;- -Zz.--ob Date +==============================================================================+ -1- 05/19/2006 \ f! ~' .. 1ft~O. UNIFIED PROGRAM INSPECTION CHECKLIST;: ".. ~)i>!':;;~~;l~V~.~";~~;'?~~~"!~"~::'-;'(_~'" ..;....;'<,.'{l'._~~-,.,-,-,~.':Jl.'..":','<ia"'J"~;;..~'<:~'.., :;.It:-.:'{:,,;'-'.\''.''".-<,.?''~'- : ;,-,,:.:.t.J'/;,".'.' "~-;"!:';' .-.. '.:.~," ~-:')!',;. i~ '.!-:' ;.....~,; ".' ::: ~.r-...!. SECTION 1: Business Plan and Inventory Program ~ BAKERSFIELD FIRE DEPT Prevention ServIces 900 Truxtun Ave.. Suite 210 Bakersfield. CA 9330 1..Ta. '" l'\ " \ L.. Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~06-L- .-38'-0 NSPECTION TIME ADDRESS A-P OL'€~ D \N~ b \e- -A L- FACILITY CONTACT S AlVb'- Section 1: Business PI8n and Inventory Progr8m o ROUTINE ~ COMBINED 0--- JOINT AGEN-CY- 0 MULTI-AGENCY-O- COMPLAINT ORE-INSPECTION C V (C=comP/iance) V=Violation OPERATION COMMENTS -b~ ~---.--C-~~~-~~---~ H ~*-'-~:-Op:-:-~,,-- O~ ApPROPRIATE PERMIT ON HAND 'Gl.0 Business PLAN CONTACT INFORMATION ACCURATE o VISIBLE ADDRESS o CORRECT OCCUPANCY o VERIFICATION OF INVENTORY MATERIALS o VERIFICATION OF QUANTITIES o VERIFICATION OF LOCATION o IlJ ------ ..---.------ --.1/f;//.rr-----.- IT,2 . V;> PROPER SEGREGATION OF MATERIAL o VERIFICATION OF MSDS AVAILABILITY o VERIFICATION OF HAl MAT TRAINING o VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES o EMERGENCY PROCEDURES ADEQUATE o CONTAINERS PROPERlY LABELED o HOUSEKEEPING o ~ FIRE PROTECTION (fJ 0 SITE DIAGRAM ADEQUATE & ON HAND . .r <. C.). _'''' ".. S '-\ \..t '-'c.- .q, I\)~Q.J .l-l 0 \ C .. ~YES o NO ANY HAZARDOUS WASTE ON SITE? EXPLAIN: LDc...~+ ~ Rl... )(;0 .. QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (881) 328-3978 C~a.)~.'---5 -r~ ,-) .. Inspector (Please Print) Fire Prevention /1111" / Shift of SlteIStatlon It ~ Business SitelSchool Responsible Party (Please Print) White - PrwenliOll Selvlces V.Dow - Stellon Copy Pink - Busin... Copy FD2049 (Rw.02I05) JOEL B. NAPOLES, DDJIÞ -- SiteID: 015-021-002309 Manager : Location: 3820 WIBLE RD C City BAKERSFIELD CommCode: BAKERSFIELD STATION 07 EPA Numb: ,,~. ~'10\ ~~ BusPhone: Map : 123 Grid: 12C (661) 832-4774 CommHaz : FacUnits: 1 AOV: SIC Code:8021 DunnBrad: Emergency Contact JOEL B. NAPOLES Business Phone: 24-Hour Phone : Pager Phone : / Title / DDS (661) 832-4774x ( ) - x ( ) - x Emergency Contact / Title / Business Phone: ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x React Hazmat Hazards: Contact : JOEL B. NAPOLES MailAddr: 3820 WIBLE RD C City : BAKERSFIELD Period : Preparer: Certif'd: ParcelNo: to Phone: (661) 832-4774x State: CA Zip : 93309 Phone: (661) 832-4774x State: CA Zip : 93309 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Owner Address : City JOEL B. NAPOLES 3820 WIBLE RD C : BAKERSFIELD Emergency Directives: ~~ jÔ.u 'g. ~OO )~ [()Ó) h~mb\9 ~i®í'1i¥y ~fba~ ~ U1~®- rry~ fJ:llZI'if'ì~ i'I~~) f(B)voe~®©1 iÛ'ß~ ~~~~®© U'u~~ú'co1íJUS M~1e¡ú'iZ1~~ m~Vì~@@r m®J~i [Q)~Vi ~©['od '0. ~\Qs. ~ ~ÛU~~ i~ ~~©~© wn~~ (w&:mo e1lIDoolrooo) ~ti1~ OOITW¡©U'ù~ ©©U'ù$~¡~~~® @l OOmlQ)~®~® ®1fiJ((] ©(QW'W'oc(( m~U'ùø ~10®m®m lQ)~~ú1 ~©ú' m~ ~®©ûij[~~. ò~ ~-j q~ Qá,r... ----- , -1- 08/14/2003 !lff/Ol ~ .' /7 Ò , 5J ðO / CITY OF BAKERSFIELD FIRE DEPARTMENT OFFiCE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave.9 3rd Floorr9 Bakersfield, CA 93301 313t¡Ò ¡23J2(}. '/O:J-I 7 FACILITY NAME ~OtL ß, f\f¡...f>O{£S INSPECTION DATE ¡(~3!o( EP A ID # C~<...bOO l {O~ Section 4: Hazardous Waste Gencrst({)1J' ProglJ'am o Routine o Combined o Joint Agency D Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Hazardous waste detennination has been made EPA ID Number (Phone: 916-324-1781 to obtain EPA 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 r/ P£.-C~ fr2ðJ.oç 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 Detennines if waste is restricted from land disposal C=Compliance V=Violation ß!MOL.n "I J Inspector: W I ,..¡ G-5 Office of Environmental Services (661) 326-3979 ~lness si\è Rés )onsible Party White - Env, Svcs. Pink - Business Copy y . CITY OF BAKERSFIEL. OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION DNEW DADO 200 D DELETE D REVISE - .--..----- ..__.-- .... --- ------- ,:: ~·.L\~:~"~~~~~:}i~i.~~{. I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME oroãA-=õCiñgBusiñess Ê)---- , -,- Joc-'t-- Þ " NNJo'LG<:. f) ()) ...,.---.-.. - -I -.- -- -.- .. ..-...... .---- CHEMICAL lOCATION .., _, 201, CHEMICAL lOCATION It..JS t Db x' R.AV i'VcM-, , CONFIDENTIAL (EPCRA) ~- - f"-'--i--~-1f'-MAP #(opÌional) .-- .... .---.---, . -- - ~-~-·203-·íGRìD # (optional)--" L_L __,,______,_______ .' ....... --.----.- II. CHI;MICAL INFORMATION .---.----.---..-. 205 TRADE SECRET o Yes 0 No 208 CHEMICAL NAME W'M-n= Ç-, ~C~ _..- ...-... . "... _. _ u _.____ ___ 207 COMMON NAME EHS· ..-.,. .------------..- -- -.-.. --.---- - .-.--- .. ,.::~y..,:: \",~\".\,;:.,." ~"+i~' 209 "If EaSjd~ áa .', .: . ,':gB?~;~i~:~~ ' ,. CAS # FIRE CODE HAZARD ClASSES (Complete if requested by local fire chief) -----------.----- (one form per material per building or ama) Page or ':<'~~'.:!(' ··i:~:<\~~\ , :'" 'f ~ '",¥. ...-:> ~,,:',,; ,I 3 .. o Yes 0 No 202 204 .' ~>^.. _ '\,:<- I ,,,',- .. ,'" 'p'x",,:-<;- ';'~~~:". ..'.::>"~: .~.:">\".~~::'~: , o Yes 0 No 206 If Subject to EPCRA. refer to instnJClions . <; . "~~ ~ ''...''}'',¿.,..,\.: 210 ..--.-.---.--."-. o w WAS;: L. R,.,OIOACTIVE DYes ONo 212 CURIES 213 ! TYPE o ) PURE o m MOmJRE PHYSICAL STATE 214 : LARGEST CONTAINER ~ 215 , --- ~.- ----.-.----. o s SOLID, o I lIaUID OgGAS ---.----.----- --.------. 01 FIRE o 5 CHRONIC HEAlTH 216 FED HAZARD CATEGORIES (Check all that appty) ANNUAl WASTE AMOUNT o 2 REACTIVE o 3 PRESSURE RELEASE 04 ACUTE HEALTH . .-.- ----- .---- --_.._._------------_. 217 MAXIMUM ; DAilY AMOUNT -l. UNITS· 218 i AVERAGE I DAilY AMOUNT ___,_ __~L__,_______,__~__u____,_,_, .s::aa GAl 0 å CU FT 0 Ib lBS 0 tn TONS . If EHS. amount must be in Ibs. '2ð !:,- 219 STATE WASTE CODE 220 STORAGE CONTAINER (Check an that apply) o a ABOVEGROUND TANK Db UNDERGROUND TANK DC TANK INSIDE BUILDING o d STEEL DRUM De PlASTlClNONMETAlllC DRUM Of CAN o 9 CARBOY o h SilO o i FIBER DRUM Cj BAG o k BOX o I CYLINDER o m GLASS BOTTLE ~LASTlC BOTTLE o 0 TOTE BIN o p TANK WAGON ..-.-....-.,.-. --- ..... .----......--- 224 STORAGÈ PRESSURE jZ(a AMBIE~, o aa ABOVE AMBIENT o ba BELOW AMBIENT .. --- -. --- .-- STORAGE TEMPERATURE o aa ABOVE AMBIENT o ba BELOW AMBIENT o C CRYOGENIC 225 221 DAYS ON SITE 222 o q RAil CAR o r OTHER 223 '..";~,,...'.~", :'·....;··"i'.' 'J; r.·¡ ~.. , '.'.. "{:HÅiARÓÓÚs.êO'MPONENT· ,,:,i::~·:('~.:,,::,'.,.:,", ,.."'} ~'''' ."".~.'". ;".",":','.¿"""'µ::~':..,: . 226 : 2 230 I I 3 234 I /4 238 5 242 227 DYes ONo 228 ._--~..._. ... -. --..--.-..-.--.- 231 0 Yes 0 No 232 I -"'-,--~----,---, ,-,----..- '" -----,...,- '----1-'--------- -~~~-- .. _~_~__u ___-~==-__:~f~:;E ~ ~._,-_._..--- ;'~Jii.·SIGNATURE . %,. '., ~'. ....'"f .~~!-;, , "" .>. .'. . , SIGNATU'RË------·..,----'-------·- '~, y; 5/ -..-...---- .--- ~- ...- ----.-.------. - -... '-'---'.' ·-P'-'.-'-.-' _.._.___._.__ UPCF (7/99) 229 233 237 S:\CUPAFORMS\OES2731.TV4.wpd LAB EMPLOYEE OPERA TORY :)PERA TORY OPERA TORY WAITING BREAK 3 2 1 ROOM ROOM XX XX ..,...."". . __'\.A ~ 'r--I =E In case of -. emergency all C" - staff and patients CD meet here. RECEPTION :xJ AREA a. RESTROOM Gorrpressor DR. . CENTRAL X RAY room OFFIC E XX ROOM . xx-eyewash sta.tion XX -oxygen ta.nk XX -firstaid kit & tray xx-fire extirguisrer