Loading...
HomeMy WebLinkAboutBUSINESS PLAN Per it .perate to Hazardous Materials/Hazardous Waste Unified Permit 'f CONDITIONS OF,·PERMIT,ON REVERSE SIDE < ..... ....... ·,,~!,··,··:·),1'~i~ft) ....' 1b11~11ø-d~u.,Im~ng: It! Hazardous Materials Plan [J Underground Storage of Hazardous MaterIals Permit ID #:: 015-000-000740 [J Risk Management Program Ò Hazardous Waste On-Site Treatment - ..,: LOCATION: 44rtO WIBLE RD- -' ufdCl ~ ):¡f cv;v . 0 ,,; 'fl vudorj ,n(OlY1p(ct - ~v,,; ; ,. -(( , ¡V ()~ ¡Vol /,'SIf¿ /êi; ,J t. oot G I fÌ (J-e/11'Cf '} [{ prvpu J.Jûtt\~t Issued by: MEMBER HOSPITAL. Charles P. Ulrich, DVM a AMERICAN G ~ ' ANIMAL S""'NL l\.NflV\A.'L- CL.IN1(.. HOSPITAL ; ASSOCIATION Bakersfield Veterinary Hospital, Inc. 4410 Wible Road· Bakersfield, CA 93313 (661) 834-6005 ..........~ ¡Bakersfield Fire Department ¡OFFICE OF ENVIRONMENTAL SER VICES- .1715 Chester Ave., 3rd Floor Approved by: ,Bakersfield, CA 93301 :Voice (661) 326-3979 ¡FAX (661) 326-0576 Expiration Date: Issue Date - June 30, 2003 f t . .~'.'" ,"'", :',' _.. ',t .;~ ..;::.':~q~~:".-:~~~,... . i. .....f'. e -~ -- ~ EAST r-----' ,¡:. I , ,¡:.. I Work Yard I Western 01, \0 ,¡:. Geophysical N X- I I (t') I ...,. C I ,¡:. Relia~1e Moving I C w , U1 J E 0 & Storage , Whse. Reliable , " \0 S I_~"_ __1 Moving & S tor I' .-t (t') S ...,. : ' .I..~""r:·-~ ...;,". t~~'" ,- // W H I T E W I B L E R 0 A D , I' i G A R L A N D R o A D --------.------ -,--', .' , Vacant , : Stock Treàtment . I Scott Insulation 0 ..... (t') ...,. L A N E t · V .H. Wible ~ arge Animal ospital & Re taining S T A B -- - -. 1 E , STOCK I PENS , , I I L__ DOWELL AUTO UP I \0 AUTO GLASS SPEC 0 (t') ...,. .VIH. WIBLE MALL ANIMAL OSPITAL JOHNSON BROTHERS INDUSTRIAL CENTER 4410 3ÖÖ:A-B-C-D-E-F-I I Ii I, I II I ! i ,¡ I I ì r , ,I I II ¡ ! I I I, t I I i I ¡ I A V E N U E , ' WEST SITE DIAGRAM - WIBLE SMALL ANIMAL HOSPITAL, BAKERSFIELD VETERINARY HOSPITAL, INC. 4410 WIBLE ROAD, BAKERSFIELD, CA 93313 740 lit¥' 7 ~" - A _ a.,1 ~~'Ú . .,- ~ - A /-/ --=- - - - - --=--; >---...-~__-~ --. .JJ e, ACCESS ROAD (NO NAME)- )I() ærH - ,{.~ ': -, vJ WATER SHUT OFF RECEPTION AREA ¡ OFFICE W I B L E Receptionist Area /."" ., ..' ~~ ~~ ; ,TOILET R o A D EXAM EXAM EXAM ROOM 1 ROOM 2 ROOM 3 ..',' ' ;" 'SURGERY 6&1" 1 T WORK AREA J. --4 WORK AREA ANIMAL TOILET X-RAY WARD X-RAY STORAGE AREA ....1'. 5D UTI! ELECTRICITY 'I, & GAS (f) SHUT N ¡;-/I5> r OXYGEN STORAGE SITE DIAGRAM, WIBLE:èSMALL ANIMAL, HOSPITAL, BAKERSFIELD VETERINARY HOSPITAL, INC. 4410 WIBLE ROAD, BAKERSFIELD CA 93313 '..... ~_ _ ø ....._.._,__.___..~. "",,_ _.' '_..n'.. :,~rF" '~. "'1' / ,I '. Ä /! ' . t. I E ! . i-- I ' , I ...,_w___._..__.______ø_....~____...~_.__···__·_···_ ACCESS ROAD (NO NAME) NOr<ífl 4410 WIBLE ROAD L<,- ~ WATER SHU~ OFF ELECTRICITY & GAS l\E'CVTtOtt AREA ~ J OFFICE SHUT í W 1\ 1 I J ! B I ¡ L E 1\ 0 A D Receptionist r---; Area r--, r-r I (<,' -< 1,C-4.;l~,',--C-.rt1,¡-f/,~:-~òmT ¡ " : ! ). .., , ' '-, / EXAM~} E' ì EXAM ',~ ROOM 1 ROOM 2 ROOM 3 tv £&-r :~'" SURGERY " I ;;>---. OXYGEN STORAGE I ':. / ÞII~r WORK AREA ANIMAL WARD I' -- I X-RAY---.J 'f,.i.~..O'~.4-!'C l.. '; I ,,/ sourlf' , , l--..:.-. ) IN CASE OF FIRE: 1. Person discovering fire will notify at least one other person to start evacuation of all personnel and animals from the building. 2. Can the Fire Depar,tment - DIAL 911 - Remain calm and give the Fire Department: a. The name and address of the Facility. b. The type of fire, if known. --------- ----- ._-. --- -.. - .---- - -~------------- - - -""-------- "----- c. Any other special information (gas explosion, etc.) that would be of help to the Fire Department or present a special hazard. 3. The Senior Person present will: a. Ascertain that all personnel and animals are evacuated. Animals will be taken to the Wible'Large Animal Building and held there until: other arrangements can be made. b. Determine whether or not the fire is to be attacked using our small Fire Extinguisher: SAFETY OF PERSONNEL AND ANIMALS HAVE PRIORITY OVER THE BUILDING AND ITS CONTENTS. I 4. Whèn)'ev8cuation is completed, all personnel will assemble in the parking lot of the Wible Large Animal Facility so the Senior Person can account for your safety. 5. The Senior Person will either make their self or designate one other person to be available to the Fire Department for Assistance and Information. All other persons stay out of the way. 6. If the fire is in the Oxygen Cylinder Storage Area - Evacuate the building and ~et away from it. Do not attempt any fi~e fighting or evacuation of contents of the building. j UNIFIED PROGRAM IN'ECTION CHECKLIST , SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 F~ITY NAME INSPECTION DATE INSPECTION TIME ,4K. V£T~ ~LHC>5 e([~----,-----------~-------- 9-19... D3 J/:~ -=c-c---- -~~~~ ADDRESS PHONE No, No, of Employees L Lf {{> W \ BL€- ~ Jii'i-="~ ------------- -_.._----_¥~------------- FACILlTYCONTACT Business ID Number D~. (.H-tH2.L£8 P CAL{l( cµ 15-021- 0OO7'iá , S~ction1: Business Plan and InvèntoryProQÌ'am LJ Joint Agency LJ Multi-Agency LJ Complaint LJ Re-inspection ( C=Compliance ) V=Violation OPERATION COMMENTS C V , -~ éiLJ ApPROPRIATE PERMIT ON HAND -------_.~-_._-,-------_._-------------- ---------------,.._-----------_._.__._---_._-~---_._._.- ..._-_.._._-------~---~.__.-.-_._-- LJ VERIFICATION OF INVENTORY MATERIALS J-I ;::r ..E? ::! ð 8 7 LJ VERIFICATION OF QUANTITIES -- --------n-~---'--t~~----u7:r 0--------------------------'.-----'---- , ~--~ERIFICATION OF LOCA~I~~--------------------'-- -----------------------,--,--,----------------------'-----------,--- BUSINESS PLAN CONTACT INFORMATION ACCURATE --,----_.-,,-,----,-,-,-- ---, -,---,------,---, ,---------,--,----, ---~---------'-- VISIBLE ADDRESS Q ~~ --------,----------------------------,,-, - ---------,-,-,----------f$,1.---,~-----..----~-,-,----, ---.-.--..,------.-...... --~~--- ._------~--- ..--.-------.----.- o CORRECT OCCUPANCY ---------.--- -----..-----.-.- -.---.--. ~_._--_..__.._...----~---_.__.~-~------- -------.--.. --..----- ----. ¿' LJ 7LJ ---~._------_._-_.._.._----------~-------------_.--_.------- PROPER SEGREGATION OF MATERIAL . ------~-----------~-_._-_._---- -.---.-------------- -_....._._----_.__._------_._--"'---_._--_.__..._._.~..----- VERIFICATION OF MSDS AVAILABILlTYE r;t[;- VERIFIC~TION OF-;AT MAT ~RAI~NG _________'n______________ ___________,_________________,__________________~_nn______,---- -I- ----.---.-------.----- ----------..-----------~.-------~-.-------.-.----.- --.-.----.-.-----.---.- rn' LJ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES .---.-.------------.---.-.--- --~-----------_._-..._-_._-----_._------_.- --_-._-------~------_._- LJ EMERGENCY PROCEDURES ADEQUATE ~CONTAIN;R~-~~~PE~LY LABELED----'-------------- -r;7-¿]H~USEKE~PING -----~---~---------- '_______n ~-~~E PROTE~TI;~------------------ -='~---'--'~--'-~---~--'-~----~' 13'" LJ SITE DIAGRAM ADEQUATE & ON HAND -------_..-----_.._-_._-_._----------------_.~----_.__.~._---------------_._.._--- -.---.----.------.------.-.-----.---.-.---.--------....-----.---------.-- ------------------------~--_._-------_._._._._--~- ..--------------------..-------.-----.---.------.------- .-....------.----. ANY HAZARDOUS WASTE ON SITE?: LJ YES ~ ~-I 5v AC'/ EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 -Jáf nv~~____~~___,____ , Inspector Badge No, -~ White· Environmental Services Yellow - Station Copy Pink - Business Copy , , r- :..:.-:' /_. . BAKERSFIELD VETERINARY HOSPITAL ~ SiteID: 015-02 Manager : Location: 4410 WIBLE RD City BAKERSFIELD CommCode: BAKERSFIELD STATION 07 EPA Numb: BusPhone: Map : 123 Grid: l3C (661) 834 - 6005 CommHaz : Low FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title , DR CHARLES P ULRICH / DR JENNIFER MCGRAW / Business Phone: (661) 834-6005x Business Phone: (661) 834-6005x 24-Hour Phone : (661) 589-3173x 24-Hour Phone : (661) 588-3400x . Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire J?ress React ImmHlth DelHlth Contact : Phone: (661) 834-6005x MailAddr: 4410 WIBLE RD State: CA Çity : BAKERSFIELD Zip : 93313 ¡ (661) pwner BAKERSFIELD VETERINARY HOSPITAL Phone: 327-4444x Address : 323 CHESTER AVE State: CA 'þity : BAKERSFIELD Zip : 93301 , Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Çertif'd: RSs: No ParcelNo: Emergency Directives: One Unified List ì All Materials at Site ì f=' Hazmat Inventory ~ Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards :NITROUS OXIDE Ç>XYGEN WASTE FIXER F P IH G F IH DH G R L t C HM.LéS p. lJt..t~Do hsr/S)©JY c®úii1v ~h2~ ~ hav$ · , (Typg or print namØf mviewsd the attach~d hæ~wdous ma~sriai$ manage- ment plan ~or 'B1ct.t&SI1OA UltM.lAM8nd ~hta~ i~ ~onGJ w¡~h (\\!sma of Buslmloo) any corr~ions 008'ü$t!tute a oompl9te alnd oorred maro- DailyMax MCP 986.00 FT3 Hi 502.00 FT3 Low 20.00 GAL Min I ~emern p~n ~())r my ~ool~. fit:' .. 03/21/2003 .:;;. , . F BAKERSFIELD;VETERINARY HOSPITAL f=~ Inventor tern 0001 'COMM NAME / CHEMICAL NAME T S OXIDE . SiteID: 015-021-000740 9 Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit STORAGE SHED ON E SIDE OF BLDG Map: Grid: CAS# 10024-97-2 - TYPE Pure PRESSURE Above Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 493.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 986.00 FT3 Daily Average 493.00 FT3 , ARD US P NEN : %Wt. RS CAS# ;1.00.00 Nitrous Oxide No 10024972 , HAZ o COM 0 TS TSecret RS BioHaz ·No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F P IH NFPA / / / USDOT# MCP Hi 0002 CHEMICAL NAME Facility Unit: Fixed Containers at Site 9 <b i Days On Site 365 , Location within this Facility Unit STORAGE SHED ON E SIDE OF BLDG Map: Grid: CAS# 7782-44-7 TYPE Pure PRESSURE Above Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 251.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 502.00 FT3 Daily Average 251. 00 FT3 I I%Wt. RS CAS # 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP INo No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS -2- 03/21/2003 "" . F B~KERSFIELD V TERINARY HOSPITAL f= ¡Inventory I em 0003 COMMON E / CHEMICAL NAME W.ASTE F ER I S, N PHOTOGRAPHIC FIXER ocation within this Facility Unit I~NSIDE DARKROOM . SiteID: 015-021-000740 ì Facility Unit: Fixed Containers at Site ì Days On ·Site 365 Map: Grid: CAS# :STATE - TYPE I1iquid Waste I PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 5.00 GAL AMOUNTS AT THIS LOCATION Dailý Maximum 20.00 GAL Daily Average 5.00 GAL , HAZARDOUS COMPONENTS I%Wt. RS CAS# Silver No 7440224 i N TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP :No No No No/ Curies R / / / Min HAZARD ASSESSME TS -3- 03/21/2003 -< . F *AKERSFIELD VETERINARY HOSPITAL I I f=:Notif./Evacuation/Medical '81 /~;ency Notification .....-eALL 911 ,./ I i I I Employee Notif./Evacuation . SiteID: 015-021-000740 9 Fast Format 9 Overall Site 9 11/05/19961 11/05/1996 WORD OF MOUTH. OUR FACILITY IS SMALL, WE DO NOT REQUIRE ALARMS OR BELLS. Public Notif./Evacuation 1l/05/1996 I I . WE DO NOT NOTIFY THE PUBLIC OR OUR NEIGHBORS. WE HAVE TWO CYLINDERS OF ~XYGEN AND ONE CYLINDER OF NITROUS OXIDE. WE HAVE NO NEIGHBORS IN CLOSE PROXIMITY. ONE PERSON IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION IS REQUIRED. Emergency Medical Plan 11/05/1996 , ' MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 OR I EDWARD P BROWN, MD - 2531 G ST - 327-7348. I -4- 03/21/2003 "2' . F BAKERSFIELD VETERINARY HOSPITAL I : f=i Mitigation/Prevent/Abatemt =/e'lease Prevention ~E USE CARE IN THE HANDLING AND STORAGE OF ÇHAINED TO PREVENT FALLING OR OVERTURNING. USE TO INSURE NO LEAKS. . SiteID: 015-021-000740 ì Fast Format ì Overall Site ì 11/05/1996 OUR CYLINDERS. CYLINDERS ARE VALVES ARE CHECKED AFTER EACH . Release Containment 11/05/1996 ~T CONSIDERED NECESSARY. IN THE EVENT OF RELEASE OF GASES, WE AERATE OUR BUILDINGS TO PREVENT HAZARDS TO THE OCCUPANTS. OUR RISK LEVEL IS VERY LOW ~D WE STORE NO POISONOUS GASES. WE KEEP ONLY OXYGEN AND NITROUS OXIDE. Clean Up 12/05/1996 NO SPECIAL TECHNIQUES, MATERIALS OR EQUIPMENT IS REQUIRED FOR THE GAS WE USE. Other Resource Activation -5- 03/21/2003 'I . F BAKERSFIELD VETERINARY HOSPITAL I f= Site Emergency Factors ~ Special Hazards Utility Shut-Offs . SiteID: 015-021-000740 9 Fast Format ì Overall Site ì I 03/26/1999 A) N CORNER OF BLDG B) CAL - NE CORNER OF BLDG ON WALL C) R - FRONT OF BLDG N SIDE CENTER b) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 03/26/1999 PRIVATE FIRE PROTECTION - WE HAVE ABC FIRE EXTINGUISHERS ON HAND FOR USE BY / OUR EMPLOXEES IF IT IS SAFE TO DO SO. ~RANT - NEAREST FIRE HYDRANT IS APPROXIMATELY 30 FT FROM THE NW CORNER OF THE BLDG ON THE E SIDE OF WIBLE RD NEAR THE ACCESS RD TO 4408 Building Occupancy Level I -6- 03/21/2003 . BAKERSFIELD VETERINARY HOSPITAL ! à\ . ,... !.. . F I I F Training . Employee SiteID: 015-021-000740 ì Fast Format ì Overall Site ì 11/05/1996 WE HAVE AT THIS FACILITY. WE SHEETS ON FILE. BRIEF SUMMARY OR TRAINING PROGRAM: WRITTEN INSTRUCTION. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, NOTIFICATION, ETC. POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. Page 2 r I I Held for Future Use Held for Future Use -7- 03/21/2003 :_ ð/S-- tPl-(){/07Yl) .' 1;}3-/Vô UNIFIED PROGRAM IN ECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 iFACIUTY NAME ,/ IINSPEyTION lATE INSPECTION TIME · -~, '1.., Ý G1,___'~f,~----', ~~':', '-:!--__ _bIt_Jy'\/lt(." -,-~~~~ç)---,'-'----,----'----'----'--'-t.' ~l_~'}-,'-_-"-__,~J,---'- '-, --,-",',--,----.._-, ,'--",,-, --,--'- ,ADDRË'ss-----'-- -- s-' PHONE No, No, of Employees 44/ò W,ßLE: 6"5 ¢2S2 10 :FÄCILITYCONTACT ------------- --- --,------",----------------------- ------------- BUsinessiDNumbe,'- - - - -----, ,.. ---- ------ ~c¡ A6tJ1 (t12e 15-021- N'e-r"J 7 v Section 1: Business Plan and Inventory Program , o Routine tfI! Combined o Joint Agency D Multi-Agency o Complaint D Re-inspection c V ( C=Compliance ) V=Violation OPERATION COMMENTS o 0 ApPROPRIATE PERMIT ON HAND ~~ .__,__..__._.___.~_.n_..._. _. .n .____.. _...... .._.. ___"__._ ._.n.._...____ _ _______...__.u _. n_ ,-- '-'---,-- ----_._._--~~---------------_._-------_.._----_.._-,. --------_.__.__.._~_.__..,---- - .-. D 0 BUSINESS PLAN CONTACT INFORMATION ACCURATE _~_____________~___._______,_..________.____ __ _______.__ ..______. ____~__..______ _._ - _. . - __.._.h______ ____ ....._....___. .__._.._. D 0 VISIBLE ADDRESS f-'----- ,-,-----------,-------------------------'-'-----,-------, -- ----,----,-,-------- --- ---,-,------ -----,-, -------,--,-, o 0 CORRECT OCCUPANCY :~~~_VER'FlCA~'ON-;,-;~~<><Y;.;"'i~~-~_- -~;.¿-~-~1-~º-~~--= - - _.._.m r-~___~__~ERIFI=_~~ON_~_~~~N~~~~ES ___________,,_________, _____ ~rL_(!.y_ _____ ___'}I~t!?_~(~_~}, __ o D VERIFICATION OF LOCATION ----~----~-~-------------~--_._-_._----------_._---------_._-----~.- l,vÇ...,¿ ~ € -S/l)E ot= ~t% -- -------------------------'--"'-'-'---------------------'- ,--, D D PROPER SEGREGATION OF MATERIAL .__._._._--~-._----------------_._._-_.- .--_.__._--~---------_....__..._-_.__.- -. .----.----------..-.... ....-...--.- ... -- . -..------.--....--- -.------ ------ -..'.-..".".---. D D VERIFICATION OF MSOS AVAILABILlTYE ____n.____.___.._.___~_______.___..________.________ _._.__..______...._.._~_. __.___n_.__ _ _.....-- _____ ..-.-----~--.. -- .--- - ... --..-.-...---..-.-.---......-.....- ... .-..---.~----. o D VERIFICATION OF HAT MAT TRAINING ~______________,_~,___u____'_'__ ,_____, _,____, ___ _,__ f-'----------- -- ------,----,--,--, -- - ,---,------,-- ,------,-- .. 0 0 VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES _ ~__,__________,___ ______,~,______,_,_,___,_,__,______ ,_______ ,________,__,_,_ ,_________________,__ _m'__' _____ _,______, ,__ ___ ,___________,___" ____________ __' D D EMERGENCY PROCEDURES ADEQUATE _____,_______,_______,_,__,__,_,_'___ ______,_______,_______,____,____________,____,__ ___,_______,____,~-"- _,_____,______ _ ______ ____'m" ",__ ..,,_____ _, __,_ .0 0 CONTAINERS PROPERLY LABELED I f~ L~ O~-..J <;;., ..(t:...J/ ______,____,_,_,_,__~__,____ m___~_'_n__ ,_____'_'m_ ,-------- _ -,-----,-----,-, -- ," -,- J----,---, ---,--------- -- -, ,------------,----,-,-----,-,' -,-," ---------,- ----,--- ,,------- - ,. -" ~~ -~ - _~~~SEKE~~~~___ -- _ _ -----~,-- ---- ,- n___ ----- ---1'--------- --- -- ,-, -- --- ----------------,----,-------"-'---------'- I 0 D FIRE PROTECTION , 1- 0 ---0 - SI~~-O-;-~~;AM'A~~~u~~-E -&--O~ --H~~~ -- - -- - --- ----- - - ------,----- --- .---- -- ________________,_________________n____ , I -...-...-.......--.-. . ANY HAZARDOUS WASTE ON SITE?: roES 0 No EXPLAIN: ~tfé:. FI',c.G't- QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 LA,) (¡v2~ 3 /\ 4-1 -L~ --'~\.i~SiteRespo~s¡¡;~----- -- --...--.---.---.---- -.-..---------.-..-- -_. ~ .--.-- --.--.------.-- ---~- ---. Inspector Badge No" White· Environmental Services Yellow . Stalion Copy Pink - Business Copy f . CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ,FACILITY NAME 7,Þ-tL. vt?('- (J.e)SP. (ý.." þ.rJ\.,..~ INSPECTION DATE 3~ z(ò} Section 4: Hazardous Waste Generator Program EP A ID # o Routine ,ø-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 EPA ID #) Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence I : Established or maintains a contingency plan and training I I 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 pLGASe FUV1Ö~ 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 I i Transports hazardous waste with completed manifest : Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal C=Compliance V=Violation £~- ¿:;:::::::::-,~_. ,-- Business Si -esponsible Party Inspector: Office of Environmental Services (661) 326-3979 White - Env. Svcs, w ( ,J'é-S Pink - Business Copy ,:.:.~:: <:_.;~~;.:~ I. FACILITY INFORMATION . ::. " o~~,;,. '.·t~;>< 8USINE;lAZ"·'~J~~;r;;·B~,-Š(~·~'~-~~~f.tt. ~LI~f~) ".------- 3 CHEMlCALLOCATIOH ,Nt;.If>ê_ ~tfC~ ¿:)tJ'!'>tOE' € :s:-,~E c;)f: ßt...D~ 201, ~~~:J~~)-- Dyes DNa 202 FA~,'LITV 10. /TI""TIB-rr:-' ¡-~ '-7--lrMÄPi(oøllo~-_HU ...,_.. ---" - -2õ3H~-GRiö¡¡{oiiiionaÏ)--- 204 ~:IL' : .....:..:;.,:;.':~..~~,';:::~'..... ~- -- .--.--...---..------. ,_ ,~~:.; "".'r__ ' II, CHEMICAL I.-IFORMATlON CITY OF BAKERSFIE~ O.CE OF ENVIRONMENTAL.RVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION j(~EW DADO D REVISE 200 D DELETE -.. ,..-----. --'.'--'-- .., . ..-. -..... -- .-- -. _... ..- ------------ ----- '," '.:, . ,;::XF~':i;\"?~:~ ¡ 205 TRADE SECRET D Yes D No 206 If SuÞjecl to EPCRA. re fIf to Instructions '"~r-- ! EHS' Dyes DNa 208 ' I CHEMICAL NAME tJ, T'ftòv ~ ð~, ()E ------,. -----------.. ...- .... .. .._---- COMMON NME - ...------------.- . ..... --.--- . -- ... .- . . ----- CAS!' FiRe CODE HAZARD a.ASSES (Comp/eIe if I8qUe11edby IOCII fire ~-------- - --- '-'---' --- ---,-,- 209 TYPE .)4.PURe -- _.~ -.-- _. ..- _....._-- - _.--- --...- ----- - ---------- (one 10"" per material per buidirtg or area) F'age d 210 D m MIXTURE ft..OtOACTIIIE D Yes ~ D w WAS;: -.. .... PHYSICAL STATE )i!g GAS 4Gf~ D . saUD D I LIQUID 214 ' LARGEST CONTAINER ---.-- ....-------.--.- .-----.---- FED HAZARD CATEGORIES (CheCk alllI1at apply) i ANNUAL WASTE , AMO~NT ~PRESSiJRE RELEASE D 1 FiRe D 2 REACTIVE o 4 ACUTE HEALTH D 5 CHRONIC HEALTH ____,_ ..._ _____________._.__4_________. 217 I" MAXlKlM 0 ôL 218 i AVERAGE .À e "'P . OAILYAMCUNT " "' CO : CAILYAMCUNT ...,..., .ð --L ._____.___1.-._.___....____..__.__ ____.._. UNITS" D ga GAL iiiit..d CU FT 0 Ib LaS 0 1/1 TONS . " EHS. _ mUll be in l1li. STORAGE CONTAINER (Chec/c an /fJat apply) o I FIBER DRUM Cj8AG Ok BOX .Ii! CYLINDER D. ABOVEGROUND TANK Db UNDERGROUNDTANK Dc TANK INSiDe BUILDING D d STEEL DRUM o . PlASTICINONMETALUC DRUM Of CAN o II CARBOy o h SILO Om GlASS BOTTLE D n PlASTIC BOTTLE D 0 TOTE BIN D p TANK WAGON ---..-- --. .__.. ..- ---.--.-..---- STORAGE PRESSURe ~.. ABOVE AMBIENT o till BELOW AMBIENT D . AMBIENT ----_._-_._-_.._-_._.-._...~_.- .. ._--- ....... .--.----.- STO~GE TEMPEAATURe ~. At.eIENT o ba BELOW At.eIENT D .. ABOVE At.eIENT 212 i CURIES 213 215 : 216 219 ¡ STATE WASTE CODE I 221 i CAYS ON SITE I :?'S- 220. 222 o q RAIL CAR o r OTHER I 223; D c CRYOGENIC 224! 2251 I j~,:,'~1}1{~5¡~~:~s'-Çò~~~ÑT:;~·;::~;»::·:: .. :-.3~·~~Å -:;~.:: .,,..... '. I 229 : _", .._.,_________.. _.. ,___'d_ __H__~__ ~-~~-9-~~-L 231 I Dyes 0 No 232 ! __._.___._,__~____._._... ..._'_._.___ _..__._.. .._ _____¡-__.___.4_____4.. _ _;-_ 235 : D yes 0 No 236 I --,- - - - - - _.- - ._--,. - , - ------1-- - Î -------_~:t~; :: : I ¥·;~.¿~::~~;7:p~!:~,I,~NÄ!y~, ,~\t' r s~TúRe ,.~,.-.--- 2 2301 I I 3 ! 234 I i 4 238 5 242 -------.-----. , PRI I L-' _~____.___.._4..__·__ ________ _.__.___ _ 4' ......... ___'. _.... __... __.._'_____"4__"__'__ r ___ UPCF (7/99) 233' 237 ¡ I i I 241 I I 245 ! I I ',~~~J¥i;~ä; DA 'J. / ' ?.I03 S:\CUPAFORMS\OES2731.TV4.wpd -,,.. ".<:' . ,,~^ 201 CHEMICAl LOCATION - D D t,...,.:I>'9....~--.:::n\--.... OVT$,..t)é £ ~'OE ~ ßt..,C(¡,. , CONFIDENTIAL (EPCRA) -- Yes No 202 FACILITY 10 II ~rr~-' :-- ·-7--1n.wri(oø~--' '""-.' --- ' . -2õ3"'TGRiÖiïCojiÏionaÏ)-- 204 , , . .,_j('1~X:;- ¡ LL~ i IL CHEMICA~~;ORM~TION -_.._-~---:- ',.'::::: '::A<':~~~\ ':::'~~§ i 205 , TRADE SECRET Dyes D No 206 If SuDjecl to EPCRA. refer to inslnletions CITY OF BAKERSFIE~ .CE OF ENVIRONMENTAL.RVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION ~EW DADO D DELETE D REVISE 2QO .-.--, ...-----. ---..--.--.. -., . ,._. _..." __ ..__ _. _... _ .._~..___4_.w_ " ::,...i~ <~~:1':(~ I. FACILITY INFORMATION BUSINESS NME(SIm.. FACILITY ÑÃMËãtõiiÄ7õOiñgšüãkiiiïšÃs')-··.. --"'" -, ., rßA~, ver-, .,:~~~. u (s.~. ~'.~~~ c,¿,,,,,, t-) CHEMICAl LOCATION ~_..'---_._-- CHEMICAL NME (!!)'f.- y ~ C-N ----..--_.. -~---------. ~.- .... .n' _. .... .._____ 'U"2õr:--- ! EHS· COMMoNNME (OM to"" pe, ma/flrlat pe, buialng Of' area) Page d . . . ~ , <- ." '.,' ,:. 7~.r-~~.~··~··,::~1;~·~:·:·· 3 CAS' Dves DNo 208 . . ---- ' --.--! . .;~'('.~·t·Io.:tr;.. ..s~~.;;..,..·.......~..., I' 209 1 "I' &lIS ~ '.... .., ~..... 1Ièa:,¡'- I . :;~~.~..\o.: :'" .~!~~. ...~ ~: -.. .......~_..... . I- ... ..~"t --'~~-'J' t - ---. ...-------- - . ...... -....-- . -- - .. . FIRE CODE HAZARDCL4SSES(CompIetejf~ltylcalflre~-------- ---,--, --- ----'----,-,- 210 D w WAS.!: -·-;~:-·,'-;.:OOA¿;:~----DY~-~No ---.t-------...--....---- ~-- 213 TYPE ø-p PURE D m MlXTtJRE 212 ¡ CURIES PHYSiCAl STATE ills GAS '2.. ~, 214 ; lARGEST CONTAINER a.saUD D I LIQUID --'-'-- --...------ -- -- ".' ._- ..---..---- ! FEDHAlARDCATEGORIES : (Check aIIlhaI apply) ¡ ANNÚAl WASTE : AMOUNT r¡/.J PRESSURE RELEASE ~ REACTIVE o 1 FIRE D 4 ACUTE HEALTH 21,5 , "-- -...-..--......---.....--.-.-----. ~^~ 218 : AVERAGE ...;;. {J "- : CAlL V AMOUNT "2..s- , --_._-----_I.-._._-_.._----_._~._- ____._._ D 98 GAL (j( d CU FT D Ib L8S 0 In TONS . " EHS. amcunt mUll be in 1bI. D 5 CHRONIC HEAl. TH 219 ¡ STATE WASTE cooe , 221 I DAYS ON SITE I -.--,- 211 ¡MAXIMUM . CAll V AMOUNT --1.. UNITS" STORAGE CONTAINER (Check aD that apply) D ¡FIBER OfWM C¡BAG D Ie BOX p¡r¡ CYLINDER D. ABOVEGROUND TANK a Þ UNDERGROUND TANK Dc TANK INSIDE BUILDING D d STEEL DRUM D. Pl.ASTICINONMETALLIC ORIJM DfCAN D S CARBOY D h SILO o m GlASS BOTTlE o n PlASTIC BOTTlE Do TOTE BIN D P TANK WAGON ----..-. --. ......, - ...--.----..---- STORAGE PRESSURE }!i,a AMBIENT ~ ABOVE AMBIENT D ba BELOW AMBIENT ---------.---------.-..-...--.- . ,.--- -.-.... --.-.--. STORAGE TEMPERATURE ? AMBIENT a sa A80VEAMBIENT 0 ba BELOW AMBIENT /'. yr~~~~/'"~~?~~~'-ÇiJ~Ç)fi~~;};~~,}: ":':;';;~~g :;~c:, ':;~~~',. ;,' __, ,. ___'____00___. ... _n ,.__n_ _____~.L~-~~-D-~~ ,L 231 ! Dyes D No 232 : __a..._.___._._______...._... ..._-_.._.~ ....-... -- .--.-ï--.-.------...-. -;- 235 ; Dyes D No 236 I ----~-~~---- .-~----~~:~~~:~: ~I ,,~!,~ ,~' ';.á~~:;~~7~pìf~~I~~!µ~ -', , ..',:;,,' { " , -š-iGÑÃTURE--'- .--- 2 2301 I I 3 ! 234 i I ï i 4 238 242 --.------- -..-. .- _. --------- -.--.--. - .... .__.. _...._... _a·.._._a._.....__..___..... _~. UPCF (7/99) 216 ' 220: 222' r 223\ D q RAIl. CAR D r OTHER ¡ 224 I o c CRYOGENIC . 2251 I 229 : 233 i 237 ¡ r 241 I 245 1 , I DA ~/tZ-/03 S:\CUPAFORMS\OES2731.TV4.wpd CITY OF BAKERSFIEI...a .CE OF ENVIRONMENTAL.RVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION ~EW DADO D REVISE 200 D DELETE -.-.. ....._---_. -_.~.__.- _.. . ---...-.... --...---.-... ._---------~---- . . ¡. .;.:.". ....,".:.." ,:,:..; ',:".;;~.; ;: ~'_ I. FACILITY INFORMATION BUSINESS NAME (s.m. _ FACILITY ÑÃMËÕtDBA -(')öi;;gBùslniiïs" Ãsï-"'''-- ...- -, - ßA<- v'2(- ~_~,_. .. (,S~_-,~!~ C.U"'¡t~) CHEMICAL LOCATION ....._------- (one fotm per ",.,.rla/ per builrllng or af'/la) Page d .';" ,,' ...,". -"~. : :,f~1!;..··~·. ':;"tt;~:: :. 3 201 CHEMICAL LOCATION - 0 0 ' CONFIDENTIAL (EPCRA) - Yes No 202 ". . -2õ3"TGRiöii{ojìÎ.ionaÎ --'- 204 ,,.., s. "l,)~- i)4"è.f<..(doÕ1V\ FACILITY 10. [[I]]][IT'-' r-- '--:---lrMAP' (oplkm8l) ---- ",,-- - .-- i i: ; , t ~_L_~.' .___.__....___.._______. - . ~,.j!~;1~X: ::i II. CHEMICAL INFORMATION ---- 205 TRADE SECRET 0 Yes 0 No 206 If SuDjec:t 10 EPCRA. relet 10 insIrucIIcns '.' -.:, ...."..- ".,,': ":'Itt:"'J- - :~::F: ,~:;-'-.·::<:~:2 i CHEr-uCAL NAME vJt\-STe F\ )tEfL -. -..----------. ...- .... .,-----.. ".,~~-- COMMON NAME I ! EHSO DYes oNo 208 ' - ----..--------.- . ...... ~_...-- . -- .... .. . -._-- . _.. I .;:.<:......,..¡,·tç4 ,..í"~~~.~~. , 209 t ·1f6HS!3 .;... ':t~iiØ~~~': ______ ___.__, ___ _,__,______,__ ~~~~~~;,:,~~;i CAS' FIRE, CODE HAZARD a.ASSES (Complete if IeC U8Ited by IocII lite éN'eð 210 .... , R.-.DIOACTIVE 0 Yes pr'No --_.~_.__.__._-_...._- ..-- i 212 CURIES 213 .---.-.------. ------.- TYPE ~ WAS;": opPlJRE o m MIXTURE PHYSICAL STATE ~UQUlD ,0 9 GAS 214 : lARGEST CONTAINER S- o . SOllO --...-------..-- - .--..--....-.. ..--.-.--- i FED HAZARD CATEGORIES : (CheCk aIIlNI apply) ¡ ANNt:JAl WASTE ¡ AMOUNT 21,5 , 217 " MAXIMUM , CAlLY AMOUNT UNrr~j.(; GAL 0 d CU FT . If EHS. amount must be in Ibt. o 3 PRESSURE RaEASE 0 4 ACUTE HEAL T1i þiK CHRONIC HEALT1i -...-- - ..._~_........_-_......_----~--~_._- .___~~~.L~~~___._~______. 219 ¡ STATEWASTECOOE o Ib LBS 0 b1 TONS 221 i DAYS ON SITE I o 1 FIRE 02 REACTIVE -.--,- "2-0 ~ STORAGE CONTAINER (Check aU /flat apply) o i FIBER DRUM OJ BAG Ok BOX o I CYlINDER Om GlASS BOme )Jr.n PlASTIC BOme o 0 TOTE BIN o p TANK WAGON o. ABOVEGROUND TANK o b UNDERGROUND TANK o c TANK INSIDE BUILDING o d STEel DRUM o e PI..ASTICINONMETAlllC DRUM Of CAN o 9 CARBOY 0" SILO -.._....... ._. .-.... . - "'--'--'-'.---"-- STORAGE PRESSURE gJ.. AMBIENT o u ABOVE AMBIENT o ba BELOW AMBIENT ----_._-_.._-------_.-.._...~_.- . -.._-- ....... ..-.-.--.--- STORAGE TEMPERAT\JRE Bf.ANe'ENT o øa ABOVE AMBIENT o Þa BelOW AMBIENT 216 220 ' 222 ' o q RAIL CAR o r OT1iER 223 224 I o c CRYOGENIC 2251 I rt}~~~~l~::;0~:~P<5ù~':~~~~NT;/;};~:' __, .,._______...___..,. ___ ,_____.,____~u ~_~~_9_~_~ ,L 231 I 0 Yes 0 No 232 ¡ ---.-¡--.-.---...---..-. -~- 235 : 0 Yes 0 No 236 I -- -~=~-=_--~~~k~; ~_: :1 ~. ': -'. ~. . . ..... ~.....". 2 230 I 3 ! 234 I i 4 238 5 242 --....-.---.-------.-.-... .._-_.._.~ .-.....---.- " , , ...-.--.-. ......... .__. __.. _.n _.._._~._.....__.,__......_ .__ --.---.-- -..-. ._. -- -------- -.--"--. .- 229 : 233 237 241 245 .,,·:f~;:~;i~¿:~,t A J 1,7-/03 UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd e e + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: 015-021-000740 + '.~ :- ~ :¡- Manager : Location: 4410 WIBLE RD Œity BAKERSFIELD BusPhone: Map : l23 Grid: l3C (661) 834-6005 CommHaz : Low FacUnits: 1 AOV: I ŒommCode: BAKERSFIELD STATION 07 EPA Numb: I +=T============================================================================+ +-~-------------------------------------+--------------------------------------+ -~~~~~~~~;-ë;~~~~~---ï----Ti~ï~-------- -~~~~~~~~;-ë;~~~~~---ï---~Ti~ï~------- IDRCHARLES P ULRICH / DR JENNIFER MCGRAW / I Business Phone: (661) 834-6005x Business Phone: (66l) 834-6005x ,24-Hour Phone : (661) 589-3l73x 24-Hour Phone : (661)~~~1ê ~ I Pager Phone : () x Pager Phone : ( L.~8' - - ZHO_y +-1-------------------------------------+--------------------------------------+ I ~azmat Hazards: Fire Press ImmHlth DelHlth I +-~----------------------------------------------------------------------------+ I <Contact: Phone: (661) 834-6005x ~aiIAddr: 4410 WIBLE RD State: CA ~ity : BAKERSFIELD Zip : 93313 +-1----------------------------------------------------------------------------+ Ðwner BAKERSFIELD VETERINARY HOSPITAL Phone: (661) 327-4444x I Address: 323 CHESTER AVE State: CA City : BAKERSFIELD Zip : 93301 +-L----------------------------------------------------------------------------+ Period to TotalASTs: = Gal I rreparer: TotalUSTs: Gal tertif'd: RSs: No I ' +-t----------------------------------------------------------------------------+ Emergency Directives: I SIC Code: DunnBrad: +=k============================================================================+ +=i Hazmat Inventory ========================================= One Unified List + +=þ Alphabetical Order ================================= All Materials at Site + +-~------------------------------+-------+-----------+-----+----------+----+---+ I! Hazmat Common Name... ISpecHazlEPA Hazards Frm I DailyMax IUnitIMCP +-~------------------------------+-------+-----------+-----+----------+----+---+ NITROUS OXIDE F P IH G 567.00 FT3 Hi I pXYGEN F IH DH G 498.00 FT3 Low ,1,C4Ltt:' 012 leI-( Do hereby certify that I have , (Type or pnnt name) I . ~evlewed the attached hazardous materials manage- ~ent plan forh¿£Jt.tI-¡l-17tia-J(l1fñKthat it along with : (Name of BusinØ88) I . ~ny corrections constitute a complete and correct man- I ~gement plan for n;ay facility. ! + -'~ - - -- - -- - -"á2- - ~tat- - - - - - - - - - ---- -- - - -- - - - - - - - - -- - -- - - -- - - - - - - - - - ---- - - + ------------ - ---- - -- -------------------------------------------------- I i -, Olf/Il.../o1-:, . 03/21/2002 ! Signature Date .~.... e e . + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: 015-02l-000740 + +=Inventory Item 0001 =============== Facility Unit: Fixed Containers at Site + +=~ COMMON NAME / CHEMICAL NAME ==============================+================+ NITROUS OXIDE I Days On Site I 365 +----------------+ I CAS# I 10024-97-2 +=~===========================================================+================+ += 'STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Gas I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER I +=~=======+==========+===============+===============+=========================+ +=4========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I 567.00 FT3 567.00 FT3 872.00 FT3 +==========================+=========================+=========================+ +=~=====+============== HAZARDOUS COMPONENTS ==============+===+===============+ I · %Wt. I IRS I CAS# I ioo.oO Nitrous Oxide No 10024972 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ I IT$eCretl RS BioHaz Radioactive/Amo~nt I EPA Hazards I NFPA I USDOT# I M~P I ¡NO No No No/ Curles F P IH / / / Hl +=======+===+======+====================+=============+=========+========+=====+ i Location within this Facility Unit STORAGE SHED ON E SIDE OF BLDG Map: Grid: I += Inventory Item +=T COMMON NAME / <DXYGEN 0002 =============== Facility Unit: Fixed Containers at Site + CHEMI CAL NAME = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = + = = = ='= = = = = = =,= = = = = + I Days On Site I 365 +----------------+ I CAS# I . 7782-44-7 I +=~===========================================================+================+ +=STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I I ~as I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER I +=~=======+==========+===============+===============+=========================+ +=b========================+ AMOUNTS AT THIS LOCATION =========================+ I . Largest Container I Daily Maximum I Daily Average I 498.00 FT3 498.00 FT3 15000.00 FT3 +=~========================+=========================+=========================+ I . +=T=====+============== HAZARDOUS COMPONENTS ==============+===+===============+ I i%Wt. I I RSI CAS# I ioo.oO Oxygen, Compressed No 7782447 +=~=====+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ IT~ecretl RSIBioHaz Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I ¡No No No No/ Curies F IH DH / / / Low +=~=====+===+======+====================+=============+=========+========+=====+ . Location within this Facility Unit STORAGE SHED ON E SIDE OF BLDG Map: Grid: -2- 03/21/2002 e e + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: 015-021-000740 + +=d=============================================================== Fast Format + +=;Notif./Evacuation/Medical ==================================== Overall Site + +=~ Agency Notification =========================================== 11/05/1996 + I I ÇALL 911 +=~=========================================================================~==+ +-~- Employee Not;f /Evacuat;on ----------------------------------- 11/05/1996 + -T- ~ . ~ ----------------------------------- BY WORD OF MOUTH. OUR FACILITY IS SMALL, WE DO NOT REQUIRE ALARMS OR BELLS. +_L___________________________________________________-------------------------+ +=I.==-P-u-b-l-~c--N-o-t-~f--/-E-v-a-c-u-a-t-~o-n--====================================-l--l/-0-5-/--1-9-96--+ -~-- ~ ~. ~ ------------------------------------ ~E DO NOT NOTIFY THE PUBLIC OR OUR NEIGHBORS. WE HAVE TWO CYLINDERS OF 0XYGEN AND ONE CYLINDER OF NITROUS OXIDE. WE HAVE NO NEIGHBORS IN CLOSE I PROXIMITY. ONE PERSON IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION IS REQUIRED. +==============================================================================+ +-~--- Emergency Med;cal Plan ------------------------------------- 11/05/1996 + ----- ~ ------------------------------------- I MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 OR I ~DWARD P BROWN, MD - 253l G ST - 327-7348. +==============================================================================+ I -3- 03/21/2002 e e ~ . ~ , + B~KERSFIELD VETERINARY HOSPITAL ===================== SiteID: Ol5-021-000740 + +==,=============================================================== Fast Format + += Mitigation/Prevent/Abatemt =================================== Overall Site + +== Release Prevention ============================================ ll/05/1996 + WE USE CARE IN THE HANDLING AND STORAGE OF GHAINED TO PREVENT FALLING OR OVERTURNING. , QSE TO INSURE NO LEAKS. OUR CYLINDERS. CYLINDERS ARE VALVES ARE CHECKED AFTER EACH , +=~============================================================================+ +--,'- Release Conta;nment ------------------------------------------ 11/05/1996 + --- ~ ------------------------------------------ ~OT CONSIDERED NECESSARY. IN THE EVENT OF RELEASE OF GASES, WE AERATE OUR BUILDINGS TO PREVENT HAZARDS TO THE OCCUPANTS. OUR RISK LEVEL IS VERY LOW AND WE STORE NO POISONOUS GASES. WE KEEP ONLY OXYGEN AND NITROUS OXIDE. I I +=~============================================================================+ +==== Clean Up ==================================================== l2/05/l996 + ~O SPECIAL TECHNIQUES, MATERIALS OR EQUIPMENT IS REQUIRED FOR THE GAS WE BSE. +=T============================================================================+ +=~=== Other Resource Activation ==============================================+ I I I +=*============================================================================+ -4- 03/21/2002 ....~ ~, .1. e e + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: 015-021-000740 + +=~=============================================================== Fast Format + += ;Site Emergency Factors ======================================= Overall Site + +== Special Hazards ======~====================================================+ I I +=~============================================================================+ +=== Utility Shut-Offs ============================================ 03/26/1999 + A) GAS - NE CORNER OF BLDG B) ELECTRICAL - NE CORNER OF BLDG ON WALL Œ) WATER - FRONT OF BLDG N SIDE CENTER B) SPECIAL - NONE :8) LOCK BOX - NO +=±============================================================================+ +_1__ Fl're Protec /Aval'l Water ----------------------------------- 03/26/1999 + -,-- .. ----------------------------------- PRIVATE FIRE PROTECTION - WE HAVE ABC FIRE EXTINGUISHERS ON HAND FOR USE BY I 0UR EMPLOYEES IF IT IS SAFE TO DO SO. I ¡ FIRE HYDRANT - NEAREST FIRE HYDRANT IS APPROXIMATELY 30 FT FROM THE NW I CORNER OF THE BLDG ON THE E SIDE OF WIBLE RD NEAR THE ACCESS RD TO 4408 I +==============================================================================+ +=b=== Building Occupancy Level ===============================================+ I I +=k============================================================================+ I -5- 03/21/2002 ---1-- I -r , " iò . e + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: Ol5-021-000740 + +=~=============================================================== Fast Format + += :Training ===================================================== Overall Site + +== Employee Training ============================================= 11/05/1996 + WE HAVE 7 EMPLOYEES AT THIS FACILITY. I WE HAVE MSDS SHEETS ON FILE. ~RIEF SUMMARY OR TRAINING PROGRAM: WRITTEN INSTRUCTION. ~OCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. I ORIENTATION ON NOTIFICATION, ETC. +==============================================================================+ +=4= Page 2 ===================================================================+ I I I +=T============================================================================+ +=~== Held for Future Use =====================================================+ I I +=~============================================================================+ +=~=== Held for Future Use ====================================================+ I +==============================================================================+ , , -6- 03/21/2002 - -- R,lD.)(-;EiV ED MAR 2 5 1999 - A BAKERSFIELD VETERINARY HOSPITAL ~ , B¥:· ~""--~...-. SiteID: 215-000-000740 : Manager : Location: 4410 WIBLE RD City BAKERSFIELD BITsP one: Map : 123 Grid: 13C (805) 834-6005 CommHaz : Low FacUnits: 1 AOV: ÇommCode: BAKERSFIELD STATION 07 :ßPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title DR CHARLES P ULRICH / DR XN AI I fâi... "-tr1 (' blA 0r '~ / . Business Phone: (805) 834-6005x Business Phone: (805) 834-6005x 24-Hour Phone : (805) 589-3173x 24-Hour Phone : (805) 5~- -;'tbO "x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: ( ) - x MailAddr: 4410 WIBLE RD State: CA çity : BAKERSFIELD Zip : 93313 Owner BAKERSFIELD VETERINARY HOSPITAL Phone: (805) 327-4444x Address : 323 CHESTER AVE State: CA Çity : BAKERSFIELD Zip : 93301 , 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 ~ As Designated Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP NITROUS OXIDE OXYGEN I, ~M.LIf:' f ¡)"Il.,cu (Typos or print name) F P IH G F IH DH G Do hereby certify that I have 567 FT3 Hi 498 FT3 Low reviewed the attached hazardous materials manage- ment plan for BA~ht-1.7 v"1Tl",,,ft'fand that it along with (Nems 01 au5in&so) any corrections oonsmuts a complete and correct man- agement plan for my facility. ~/ úd- Signature )0" 3' /tr.!i1 Dale -1- 03/01/1999 e F BAKERSFIELD VETERINARY HOSPITAL f= Inventory Item 0001 r== COMMON NAME / CHEMI CAL NAME NITROUS OXIDE . SiteID: 215-000-000740 ì Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit STORAGE SHED ON E SIDE OF BLDG Map: Grid: CAS # 10024-97-2 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 567.00 FT3 567.00 FT3 872.00 FT3 %Wt. RS CAS # 100.00 Nitrous Oxide No 10024972 HAZARDOUS COMPONENTS T TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi HAZARD ASSESSMEN S f= Inventory Item 0002 === COMMON NAME / CHEMI CAL NAME OXYGEN Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit STORAGE SHED ON E SIDE OF BLDG Map: Grid: CAS # 7782-44-7 'STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 498.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 498.00 FT3 Daily Average 15000.00 FT3 HAZARDOUS COMPONENTS '%Wt. RS CAS # 100.00 Oxygen, Compressed No 7782447 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -2- 03/01/1999 e e F BAKERSFIELD VETERINARY HOSPITAL I f= Notif./Evacuation/Medical r=: Agency Notification L:ALL 911 SiteID: 215-000-000740 ì Fast Format ì Overall Site ì 11/05/19961 11/05/1996 Employee Notif./Evacuation BY WORD OF MOUTH. OUR FACILITY IS SMALL, WE DO NOT REQUIRE ALARMS OR BELLS. Public Notif./Evacuation 11/05/1996 WE DO NOT NOTIFY THE PUBLIC OR OUR NEIGHBORS. WE HAVE TWO CYLINDERS OF OXYGEN AND ONE CYLINDER OF NITROUS OXIDE. WE HAVE NO NEIGHBORS IN CLOSE PROXIMITY. ONE PERSON IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION IS REQUIRED. Emergency Medical Plan 11/05/1996 MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 OR EDWARD P BROWN, MD - 2531 G ST - 327-7348. -3- 03/01/1999 e e F BAKERSFIELD VETERINARY HOSPITAL I f= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-000740 ì Fast Format ì Overall Site ì 11/05/1996 WE USE CARE IN THE HANDLING AND STORAGE OF OUR CYLINDERS. CYLINDERS ARE CHAINED TO PREVENT FALLING OR OVERTURNING. VALVES ARE CHECKED AFTER EACH USE TO INSURE NO LEAKS. Release Containment 11/05/1996 ~OT CONSIDERED NECESSARY. IN THE EVENT OF RELEASE OF GASES, WE AERATE OUR BUILDINGS TO PREVENT HAZARDS TO THE OCCUPANTS. OUR RISK LEVEL IS VERY LOW AND WE STORE NO POISONOUS GASES. WE KEEP ONLY OXYGEN AND NITROUS OXIDE. Clean Up 12/05/1996 NO SPECIAL TECHNIQUES, MATERIALS OR EQUIPMENT IS REQUIRED FOR THE GAS WE USE. Other Resource Activation -4- 03/01/1999 ~ e e F BAKERSFIELD VETERINARY HOSPITAL I p= Site Emergency Factors r== Special Hazards Utility Shut-Offs SiteID: 215-000-000740 ì Fast Format ì Overall Site ì I 11/05/1996 A) GAS - NORTHEAST CORNER OF BUILDING B) ELECTRICAL - NORTHEAST CORNER OF BUILDING ON WALL C) WATER - FRONT OF BUILDING NORTH SIDE CENTER D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 11/05/1996 PRIVATE FIRE PROTECTION - WE HAVE ABC FIRE EXTINGUISHERS ON HAND FOR USE BY OUR EMPLOYEES IS IT IS SAFE TO DO SO. FIRE HYDRANT - NEAREST FIRE HYDRANT IS APPROXIMATELY 30 FEET FROM THE NORTHWEST CORNER OF THE BUILDING ON THE EAST SIDE OF WIBLE ROAD NEAR THE ACCESS ROAD TO 4408 WIBLE ROAD. Building Occupancy Level -5- 03/01/1999 · e e F BAKERSFIELD VETERINARY HOSPITAL I F Training Employee Training SiteID: 215-000-000740 ì Fast Format ì Overall Site ì 11/05/1996 WE HAVE 7 EMPLOYEES AT THIS FACILITY. WE HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OR TRAINING PROGRAM: WRITTEN INSTRUCTION. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, NOTIFICATION, ETC. I POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. Page 2 [ I I Held for Future Use Held for Future Use -6- 03/01/1999 ---.~,._--,._--~- 1""-- -__ ______.~_v_.__ ,_ _ __....v___ Per...Ït ÒÕ'. to Operil.te Hazardous Materials/Hazardous Waste Unified Permit I CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: , ':tt@~ardous Materials Plan " """e,,~ground Storage of Hazardous Materials agement Program Waste 4410 PERMIT ID# 01S-Q21.Q00740 , ...' BAKERSFIELD VETERINARY LOCATION Issued by: WIBLE I B¡tkersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor B:ûtersfield, CA 93301 V òice (805) 326-3979 F~ (805) 326-0576 J *~ ph Huey, ffice of ental Servi es June 30, 2000 Approved by: Expiration Date: ..... ,. ..,~ -··r ." _..... - '- .~- - .¡ e e + BAKERSFIELD VETERINARY HOSP '==f====~J======== SiteID: 215-000-000740 + Operator: 0 fE~fEu'WlfE /'BusPhone: (805) 834-6005 Location: 4410 WIBLE RD I "Map: 123 OvrlHaz ': Low C~ty BAKERSFIELD FacUnits: 1 AOV: CqmmCode: BAKERSFIELD STAT! 6yO~ SIC Code: EEA Numb: . 'V 'DunnBrad: +==~===========================================================================+ +=======================================+======================================+ t Emergency Contact / Title 1 Emergency Contact / Title .CHARLES P ULRICH / - CYNTHIA L DAHLGREN / Business Phone: (805) 834-6005x Business Phone: (805) 834-6005x ~4-Hour PHone: (805) 589-3173x 24-Hour PHone: (805) 872-0189x Eager Phone : () x Pager Phone : ( ) - x +--~------------------------------------+--------------------------------------+ I Hazmat Hazards: Fire Press ImmHlth DelHlth I +--~---------------------------------------------------------------------------+ Contact : Phone: () x M~ilAddr: 4410 WIBLE RD State: CA City : BAKERSFIELD Zip : 93313 +--~---------------------------------------------------------------------------+ Owner : BAKERSFIELD VETERINARY HOSPITAL Phone: (805) 327-4444x Address : 323 CHESTER AV State: CA C.il~y,---,----,:--,BAKERS_FI,ELD Zip : 93301 +--~---------------------------------------------------------------------------+ Period to TotalASTs: = Gal P~eparer: Tota1USTs: = Gal Certif'd: EHSs: No +--~---------------------------------------------------------------------------+ First Response Directives: , +==============================================================================+ += Hazmat Inventory ========================================= One Unified List + +== :MCP+DailyMax Order ================================= All Materials at Site + +--~-----------------------------+-------+-----------+-----+----------+----+---+ I Hazmat Common Name... ISpecHazlEPA Hazards Frm I DailyMax IUnitIMCP +--~-----------------------------+-------+-----------+-----+----------+----+---+ NI1ROUS OXIDE F P IH G 567 FT3 Hi OXYGEN F IH DH G 498 FT3 Low <r Ð¥tLtJ A. tJ¡(f(1ftJI11 I,. (T' Do hereby certify that I have I ype or pnnt name) '. re~iewed the attached hazardous materials manaQß- . &K~1P1t:LÙ VET'EÆ¡.v..t/tJ.j m~nt plan for #V,¥:!,T4L. " and that it along wLth ( ame of Business) ,- any corrections constitute a complete and correct maJ1r I " , agament plan for my facility. +==T===========================================================================+ ',~ .: h(¡jJ/;; -_1- · e e + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: 215-000-000740 + += ~nventory Item 0001 =============== Facility Unit: Fixed Containers at Site + +== :COMMON NAME / CHEMICAL NAME ==============================+= Days On Site =+ N]TROUS OXIDE I 365 I +----------------+ Location within this Facility Unit I CAS# I S~ORAGE SHED ON E SIDE OF BLDG 10024-97-2 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Gas I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER I +=========+==========+===============+===============+=========================+ +========================== AMOUNTS STORED AND IN USE =========================+ I L~gst Cont.this Loc FT3 I DailyMax this Loc FT3 DailyAvg this Loc FT3 I : 567.00 567.00 872.00 +--~---------------~-------+-------------------------+-------------------------+ :DailyMax Stored FT3 I DailyMax Open Use FT3 DailyMax Closed Use FT3 I +==~=======================+=========================+=========================+ +==~====+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I IEHS CAS# I 100.00 Nitrous Oxide No 10024972 +==d====+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ Tsecret EHSIBioHaz Radioactive/Amount I EPA Hazards I NFPA I USDOT# I M~P I No No No No/ Curies F P IH / / / H~ +--,----+---+------+--------------------+-------------+---------+--------+-----+ UFC Article 80 Control Zone: USDOT Hazards In Cabinet? Sprinklered Area? +==~====================================+======================================+ +========================== MISC. LOCAL AGENCY DATA ===========================+ ~g.Defined1: Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.define10: +- Ag.Definell ----------------------------------------------------------------+ +==1===========================================================================+ -2- e - + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: 215-000-000740 + += ~nventory Item 0002 =============== Facility Unit: Fixed Containers at Site + +== 'COMMON NAME / CHEMICAL NAME ==============================+= Days On Site =+ O~YGEN I 365 I +----------------+ CAS# S~ORAGE SHED ON E SIDE OF BLDG 7782-44-7 +==~==========================================================+================+ , += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Gás I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER I +=========+==========+===============+===============+=========================+ +==~======================= AMOUNTS STORED AND IN USE =========================+ I L~gst Cont.this Loc FT3 I DailyMax this Loc FT3 I DailyAvg this Loc FT3 498.00 498.00 15000.00 +--~-----------------------+-------------------------+-------------------------+ I ;DailyMax Stored FT3 I DailyMax Open Use FT3 DailyMax Closed Use FT3 I +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I IEHS CAS# I 100.00 Oxygen, Compressed No 7782447 +==~====+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ ITsecretlEHSIBioHaz Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I No NQ No No/ Curies F IH DH / / / Low +--¡----+---+------+--------------------+-------------+---------+--------+-----+ UEC Article 80 Control Zone: USDOT Hazards ¡Location within this Facility Unit In Cabinet? Sprinklered Area? +=======================================+======================================+ , +==~======================= MISC. LOCAL AGENCY DATA ===========================+ Ag.Defined1: Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined7: ~g.Defined5: Ag.Defined6: Ag.Defined8: Ag.Defined9: Ag.define10: +- Ag.Define11 ----------------------------------------------------------------+ +==~===========================================================================+ , -3- ~- e ~~ -. + BAKERSFIELD VETERINARY HOSPITAL =========~=========== SiteID: 215-000-000740 + +==f======================================================~======= Fast Format + += ~otif./Evacuation/Medical ==================================== Overall Site + +== Agency Notification ==================7======================== 11/05/1996 + / C~LL 911 +==~======================================================~====================+ +==? Employee Notif./Evacuation ==========================~======== 11/05/1996 + , I BY WORD OF MOUTH. OUR FACILITY IS SMALL, WE DO NOT REQUIRE ALARMS'OR BELLS. +==~===========================================================================+ +__L_ Publ4c Not4f /Evacuat4on ------------------------------------ 11/05/1996 + --T- ¿ · . · ------------------------------------ I WE DO NOT NOTIFY THE PUBLIC OR OUR NEIGHBORS. WE HAVE TWO CYLINDERS OF I OXYGEN AND ONE CYLINDER OF NITROUS OXIDE. WE HAVE NO NEIGHBORS IN CLOSE P~OXIMITY. ONE PERSON IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION IS REQUIRED. +==f===========================================================================+ +==*== Emergency Medical,Plan===========~========================= 11/05/1996 + I " . ..,:. . ~ '.." I M~RCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 OR EDWARD ,P-BROWN, MD,~ 2531 G ST - 327-7348. , +==~===========================================================================+ -4- e e I + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: 215-000-000740 + +================================================================= Fast Format + += ~itigation/Prevent/Abatemt =================================== Overall Site + +==iRe1ease Prevention ============================================ 11/05/1996 + ¡ i WE USE CARE IN THE HANDLING AND STORAGE OF CHAINED TO PREVENT FALLING OR OVERTURNING. I USE TO INSURE NO LEAKS. OUR CYLINDERS. CYLINDERS ARE VALVES ARE CHECKED AFTER EACH +==~===========================================================================+ +==~ Release Containment ========================================== 11/05/1996 + NOT CONSIDERED NECESSARY. IN THE EVENT OF RELEASE OF GASES, WE AERATE OUR I , BUILDINGS TO PREVENT HAZARDS TO THE OCCUPANTS. OUR RISK LEVEL IS VERY LOW AND WE STORE NO POISONOUS GASES. WE KEEP ONLY OXYGEN AND NITROUS OXIDE. I +==d===========================================================================+ i / +==~= Clean Up ==================================================== 11/05 1996 + Nq SPECIAL TECHNIQUES, MATERIALS OR EQUIPMENT IS REQUIRED FOR THE GASS WE U~E. I +==9===========================================================================+ +===== Other Resource Activation ==============================================+ ¡ +==+===========================================================================+ -5- t'I' '. e e + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: 215-000-000740 + +==~============================================================== Fast Format + += Site Emergency Factors ======================================= Overall Site + +==;Special Hazards ===========================================================+ i +==~===========================================================================+ +==~ Ut1l1ty Shut-Offs ============================================ 11/05/1996 + A) GAS - NORTHEAST CORNER OF BUILDING B) ELECTRICAL - NORTHEAST CORNER OF BUILDING ON WALL C) WATER - FRONT OF BUILDING NORTH SIDE CENTER D) SPECIAL - NONE E) LOCK BOX - NO +==~=================~=========================================================+ +__l_ F1"re Protec /Ava1'1 Water ----------------------------------- 11/05/1996 + ---- ----------------------------------- , ." PRIVATE FIRE PROTECTION - WE HAVE ABC FIRE EXTINGUISHERS ON HAND FOR USE BY I O~R EMPLOYEES IS IT IS SAFE TO DO SO. FiRE HYDRANT - NEAREST FIRE HYDRANT IS APPROXIMATELY 30 FEET FROM THE I N0RTHWEST CORNER OF THE BUILDING ON THE EAST SIDE OF WIBLE ROAD NEAR THE AœCESS ROAD TO 4408 WIBLE ROAD. I +==~===========================================================================+ -6- ~ e e + BAKERSFIELD VETERINARY HOSPITAL ===================== SiteID: 215-000-000740 + +==b============================================================== Fast Format + += ~ite Emergency Factors ======================================= Overall Site + +==~== Building Occupancy Level ===============================================+ i +==~===========================================================================+ -7- e e + B~ERSFIELD VETERINARY HOSPITAL ===================== SiteID: 215-000-000740 + +==+============================================================== Fast Format + += training ===================================================== Overall Site + +==¡Employee Training ============================================= 11/05/1996 + WE HAVE 7 EMPLOYEES AT THIS FACILITY. r WE HAVE MSDS SHEETS ON FILE. I i ' . BRIEF SUMMARY OR TRAINING PROGRAM: WRITTEN INSTRUCTION. L0CATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. ORIENTATION ON NOTIFICATION, ETC. +==f===========================================================================+ +==~ Page 2 ===================================================================+ +==~===========================================================================+ j -8- ~ .. - e / ~ 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000740 Overall Site with 1 Fac. Unit Page 1 General Information / Location: 4410'WIBLE RD Map: 123 Hazard: Low Community: BAKERSFIELD STATION 07 Grid: 13C FlU: 1 AOV: 0.0 - Contact Name Title Business Phone - , 24-Hour Phone CHARLES P ULRICfI (805) 834-6005 x (805) 589-3173 CYNTHIA L DAHLGREN (805) 834-6005 x (805) 872-0189 Administrative Data Mail Addrs: 4410 WIBLE RD D&B Number: City: BAKERSFIELD State: CA Zip: 93313- Corom Code: 215-007 BAKERSFIELD STATION 07 SIC Code:' ~ Owner: BAKERSFIELD VETERINARY HOSPITAL Phone: (805) 327-4444 Address: 323 CHESTER AV State: CA City: BAKERSFIELD Zip: 93301- Summary RECEIVED ISfP 0 1 1993 HAZ. MAT. DIV. ()~ 't CI(~L-ø r. ú ¡,R, ,cLt- Do hereby certify that t have ype Dr print name) reviewed the attached hazardous materials manage- ment plan for '&~fl/.'\AI ÚEt, {-to~P. and that it along with (Name Df Business) , any corrections constitute a complete and correct man- agement plan for my facility. ~/.1 i~ Signature 7/5"/73 Dat!) ......, . - e 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000740 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-002 NITROUS OXIDE Gas 567 High ~ Fire, Pressure, Immed HIth FT3 02-001 OXYGEN Gas 498 Low ~ Fire, Pressure, Immed HIth FT3 ~c .....- . e 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000740 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 027002 NITROUS OXIDE . Fire, Pressure, Immed Hlth Gas 567 High FT3 CAS #: 10024-97-2 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3 ----r--, Daily Average FT3 ~ Annual Amount FT3 567 ' I 567.00 872.00 Storage r Press T Temp -:ì Location PORT. PRESS. CYLINDER Above Ambient STORAGE SHED ON EAST SIDE OF BLD - Conc l 100.0% Nitrous Oxide Components ~ MCP ---¡G, uide High I 14 02-001 OXYGEN . Fire, Pressure, Immed Hlth Gas 498 Low FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3 ----r-- Daily Average FT3 ~ Annual Amount FT3 498 , 498.00 15,000.00 Storage r Press T Temp -:ì Location PORT. PRESS. CYLINDER Above Ambient STORAGE SHED ON EAST SIDE OF BLD - Conc -I 100.0% Oxygen, Compressed Components I~ MCP ---¡Guide Low I 14 e e 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000740 00 - Overall Site Page 4 <D> Notif./Evacuation/Medical <1> Agency Notification \ CALL 911 <2> Employee Notif./Evacuation BY WORD OF MOUTH. OUR FACILITY IS SMALL, WE DO NOT REQUIRE ALARMS OR BELLS. <3> Public Notif./Evacuation WE DO NOT NOTIFY THE PUBLIC OR OUR NEIGHBORS. WE HAVE TWO CYLINDERS OF OXYGEN AND ONE CYLINDER OF NITROUS OXIDE. WE HAVE NO NEIGHBORS IN CLOSE PROXIMITY. ONE PERSON IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION IS REQUIRED. <4> Emergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 OR EDWARD P. BROWN, M.D. 2531 G ST 327-7348 e e 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000740 00 - Overall Site Page 5 <E> Mitigation/Prevent/Abatemt <1> Release Prevention WE USE CARE IN THE HANDLING AND STORAGE OF OUR CYLINDERS. CYLINDERS ARE CHAINED TO PREVENT FALLING OR OVERTURNING. VALVES ARE CHECKED AFTER EACH USE TO INSURE NO LEAKS. <2> Release Containment NOT CONSIDERED NECESS. IN THE EVENT OF RELEASE OF GASES, WE AERATE OUR BUILDINGS TO PREVENT HAZARDS TO THE OCCUPANTS. OUR RISK LEVEL IS VERY LOW AND WE STORE NO POISONOUS GASES. .WE KEEP ONLY OXYGEN AND NITROUS OXIDE. <3> Clean Up NO SPECIAL TECHNIQUES, MATERIALS OR EQUIPMENT IS REQUIRED FOR THE GASES WE USE. <4> Other Resource Activation ~. ~ e e 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000~000740 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NORTHEAST CORNER OF BUILDING B) ELECTRICAL - NORTHEAST CORNER OF BUILDING ON WALL C) WATER - FRONT OF BUILDING NORTH SIDE CENTER D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - WE HAVE ABC FIRE EXTINGUISHERS ON HAND FOR USE BY OUR EMPLOYEES IS IT IS SAFE TO DO SO. FIRE HYDRANT - NEAREST FIRE HYDRANT IS APPROXIATELY 30 FEET FROM THE NORTHWEST CORNER OF THE BUILDING ON THE EAST ElSE OF WIBLE ROAD NEAR THE ACCESS-ROAD TO 4408 WIBLE ROAD. <4> Building Occupancy Level Of.. t:. - e 06/30/93 BAKERSFIELD VETERINARY HOSPITAL 215-000-000740 00 - Overall Site Page 7 <G> Training <1> Page 1 WE HAVE 7 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: WRITTEN INSTRUCTION. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, NOTIFICATION, ETC. POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use "-r General Information RECE I vgUge OCT, 6 1990- Ans'd. ......".... 1 BAKERSFIE. VETERINARY HOSPITAL 215__0-000740 Overall Site with 1 Fac. Unit (~8/27 /90 LClcat i,:)Y,: 4410 WIBLE RD Map: 123 Hazard: Lc.w Ident Number: 215-000-000740 Grid: 13C Area clf Vul: 0.0 ,---- CC,y,t act Name Title Busiy,ess Ph.:ly,e - 24 H 1:11.\1''' Phc.y,_e, , .'ciÏÂRi.ES. 'P:-uiRIcH '. (805) 834-6005 x (805) . èj~~6k3~'_~1 ~-, CYNTH I A -- L. DAHÍ.GREN " (805) 834-6005 x (805) - Adrniytistrat ive Data Mai I Addr"s: 4410 WIBLE RD D&B Number" : City: BAKERSFIELD State: CA Zip: 93313- Cc.r.1m Cc.de: 215-007 BAKERSFIELD STATION 07 SIC C,:,de: Owner: BAKERSFIELD VETERINARY HOSPITAL Ph cIne: ( 805 )~327;;~1/1/1 ; Address: 323 CHESTER AV State: CA City: BAKERSFIELD Zip: 93301- Summary (()~ ~, WILFRED G. OWEN JTyp3 or print n&me) Do hereby ©srtify ~hat ~ hav~ reviewed the attached hazardous materials managsa ment plan for BVH-wsA and that it along with (Name oi j1i,;j!1e¡¡s/ ~ny corrections consmute a complete and correct man- agement plan for my facility. (J)¥f1 ,~ 10-1-90 Daw ~~ '''\> '. BAKERSFIE. VETERINARY HOSPITAL 215_0-000740 HazMat Inventory List in Reference Nu~ber Order Page 2 (:i>8/27/'30 02 - Fixed Containers on Site Pln-Ref NaMe/Hazards FClrM QuaYlt ity MCP 02-001 OXYGEN Cyli&ler 4'38 LCIW FT3 02-001 NITROOS OXIDE Cylinder 130 Fr3 High '\ BAKERSFIE. VETERINARY HOSPITAL 215__0-000740 00 - Overall Site Page 3 Ø8/27/90 <D> Notif./Evacuation/Medical <1> Agency Notification Kern COunty Fire Depart:Iœnt (DIAm911) <2> Employee Notif./Evacuation By word of mouth. Our facility is small, we do not require alanns or bells. <3> Public Notif./Evacuation \e do not notify the public or our neighbors. We have two cylinders of Oxygen and one cylinder of Nitrous Oxide. We'Mve nó neighbors in close pro~ty. One person is designated to ask the Senior Fireman present if notification is required. <4> Emergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 OR EDWARD P. BROWN, M.D. 2531 G ST 327-7348 "\ BAKERSFIE. VETERINARY HOSPITAL 215.0-000740 00 - Overall Site Page 4 ~8/27/90 <E> Mitigation/Prevent/Abatemt <1> Release Prevention ~ use care in the handling and storage of our cylinders. Cylinders are chained to prevent falling or overturning. Valves are checked after each use to insure no leaks. <2> Release Containment Not considered necessary. In the eent of release of gases, we aerate our buildings to prevent hazard to the occupants. Our risk level is very low and we store no poisonous gases. ~ keep only Oxygen and Nitrous Oxide. <3> CleaYI Up No special teclmiques, materials :m£ equiµœnt is required for the gases we use. <4> Other Resclurce Act i vat iC'YI · ¡ BAKERSFIE_ VETERINARY HOSPITAL 215"-0-000740 00 - Overàll Site Page 5 Ç.l8/27/90 <F> Site Emergency Factors <1> Special Hazards ilily in confined spaces. (2) Utility Shut-Offs A) GAS - NORTHEAST CORNER OF BUILDING B) ELECTRICAL - NORTHEAST CORNER OF BUILDING ON WALL C) WATER - FRONT OF BUILDING NORTH SIDE CENTER D) SPECIAL - NONE E) LOCK BOX - NO (3) Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - ???????????? We have "AOC" fire extinguishers on hand for use by our employees if it is safe to do so. FIRE HYDRANT - ???????????? (4) Held for Future use Nearest fire hydrant is approximately .30 feet fran·the Nòrth--west comer of the building on the east side of Wible Road near the access road to 4408 Wible Road. ~, BAKERSFIE. VETERINARY HOSPITAL 215__0-000740 00 - Overall Site Page E, ~8'/27 /'30 <G} TrainiY'lg < 1> Page 1 WE HAVE 7 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: ,. 1. Written Instructions. 2. Orientation on location of extinguishers, cylinders, evacuat~on routes, notification, etc. 3. Posted Fire Plans and ''Hazardous Materials" infonnation. <2} Page 2 as needed <3} Held for Future Use <4} Held for Future Use " HAZARDOUS MATERIALS INVENTORY Farm and Agticulture [] Standard Business ~ BAKERSF I ELD VETER I NARY N 0 ~AKE¡~tr} {¡Urn I NA~ E eRE T S Page I BïSINE~S NAME: HOSPITAL, INC. OWNER NAME: HOSPITAL, INC. NAME OF THIS FACILITYÓ'WIB~L, S~ALL ANIMAL HOSPITAL L bAT! N' 4410 Wible Road __ A~DRESSl' _-2.2..Ì-Che!;ter Avenue STANDARD IND. CLASS C DE: _,_ _____ __.____ C Y,. IP:_--!iaJœr..sí.i.e1.d..._,Ç,aJJ,fur..nia 9331.3..__ C TY~ Z P:_B.aJœr.diplrl, r.,, ifnnri" Q'l'ln1 DUN AND BRADSTREET NUMBER PiNt:: (R{)<j~ R'I4-1{){)<j P ON it· -L80.5.~.3..27~ - - -- - ---- REFE to lN~'fffUc.,T1UNS-roR-PROPER CODES - - - - - - - - - 3 12 13 It ~u locat ion Where 'by Hues of ~hture{cc"conents Allt Stored In FaCIlity vt See Instruc Ions STORAGE SHED ON EAST i - CITY of J BAKEHSt-:IELD of I i' II [ "f I Ii I I I I I I I I I' I Trans Code u Physical fnd Health Hafard (Check a I that apply C.A.S. Number 7782-44-7 r1XFire Hazard [] Reactivity [] Dela{ed ôXSuddi!n Release Hea th of Pressure 27 Component.1 Name I C.A.S. Number nax Component.2 Name I C.A.S. Number u-Immediate Health Component.3 Name & C.A.S. Number U M 65 Physical fnd Health Hafard ¡Check a I that apply NITROUS OXIDE ~xFire Hazard [] Reactivity [] Delayed ~Suddi!n Release Health of Pressure Nalle & C.A.S. Number COllponent.2 Hame & C.A.S. Number ~ Immediate Health Component.3 Halle & C.A.S. Number Physical 8nd Health Ha~ard (Check all that applYI C.A.5. Number Component.1 Ha~e & C.A.S. Humber o Fire Hazard [] Reactivity [] Delayed [] Suddi!n Release Health Of Pressure Component.2 Name & C.A.S. NUllber [] Immediate Health Component.3 Name & C.A.S. NUllber EMERGENCY CONTACTS #1 DR. C;, P. ULR I CH VETER I NAR I AN (805i1~5B9.-3]J3- ' 1t2 DR. C. LOoDAHLGREN RIlle TnJe, r rlfõñ"e----:- Rue íertifjeatioq (Re~d and $ign afjf3r cÇJmp7~ting. a77. sec~ions) . . . , certIfy un~er penaltï 0 law th,t I have persona I~l exanlneo oqd 81 familIar Ylth the Information $ubmltted In this ond all attaçhed dQcu~ents, ano t at based,on my Inquiry 0 hose IndIViduals responsible for obtaIning the InformatIon. I belIeve that the;¡þt' , ~ submItted Information IS true, accurate, and complete. , I' / / ' WILFRED G. OWEN, BUSINE~S MANAGER tIlI' . fl~."e at'<I orlchl ttt1é Of O'inH/oper!tor UH ollner/operator's authorlZeo representative mõã!ur . ' ' [] Fire Hazard [] De Ia{ed [] Sudden Re 1 ease Hea th of Pressure [] Reactivity " þ.--;" ---- -- Component'2 Hame I C.A.S. Number [] Immediate Health Component.3 Name & C.A.S. NUllber VETE~INARIAN T1te (805) 873-0~Q4___ 2Tì1ftñ n ~ oct 1, I 990 lJnnfqr.e e . CITY oj' BAKERSFIELD "WE CARE" FIRE DEPARTMEm D, S NEEDHAM FIRE CHIEF 2101 H STREET BAKERSFIELD. 93301 326-3911 September 4, 1990 Mr. Terry M. Sippel Bakersfield Veterinary Inc. 4410 Wible Road Bakersfield, Ca. 93313 Dear Mr. Sippel: Enclosed you will find a computer printout of the Hazardous Materials Management Plan that is currently in our computer, we have highlighted the areas that need to be revised. Also due to a change in the law that went into effect January, 1989, we need to have a new inventory form (enclosed) filled out. These forms ~ be filled out and returned to our office by September 28, 1990. If you have any questions please don't hesitate to contact us at (805) 326-3979. Sincerely Yours, Ralph E. Huey Hazardous Materials Coordinator REH:vp Enclosures d- )~.. ~~~ @J21 Bakersfield Fire Dept. Hazardous Materials Inspection NU JO-/ð-f1 (SA1A--// A/Jf/11".b) Adequate Inadequate Verification of Inventory Materials RECEIVED D ~ Verification of Quantities OCT 1 7 '989 0 D HA7.. MAT. CIV. Verification of Location ~ D Proper Segregation of Material ~ D Comments: ~ /1J.;) 0 ¿,J J 7hvk:. uexf fo O~ , Verification ofMSDS Availability ~ 0 Date Completed Business Name: /6A/<Z-rshL./c/ /;/-l!/l-erIAJ /'1-r¡ hto:.;p Location: "'I J/ / b LV ~ J / ~ Plan 10 # 215-000 ðttl7~D(Top right comer Business Plan) Station No. 7 Shift C- ¡;. LU~f:}5 Inspector Number of Employees 7 3;) 1-I}Lf if~ uJLL Verification of Haz Mat Training Comments: ~ D Verification of Abatement Supplies & Procedures Comments: ~ D Emergency Procedures Posted Containers Properly Labeled Comments: ~ [2šf D D Verification of Facility Diagram Special Hazards Associated with this Facility: D D Violations: FD 1652 (Rev. 3-89) White-Haz,Mat Div. Yellow-Station Copy Pink-Business Office " . - " -, ,-- ~> q¡':~;--'.5 "'-,,~ "\'.r, ,:'-';;;-~. J." .f~ .." "," "",./' ~ <' ~~j . .:!,..t ~ :'1 .~r.r .. .'.' :;..~~I!·~r ---;;; 'Z-'''--I"''t :~:..:~'~';," .~ ;. ;\ ¡,._~~~. - - --~r'¡:'\'1,\;:" ~>"-"'f . -I· ....,'''.... :-·.....-'Y,>;;·.-.::~~r~....,¡;----t..;:;:--'1 ' . e , ' J-Ij-q / S.p~ ~ wJJ -~;'rL~ ~ Wq4 JU.~.ø. ·tiA~ , "1t~~~J ~Q-Q,.(.~) t '. :.,~ L: " '. _ . . ~ ~.. -' ".' .. -\ \ '\ '," ". ' . ., \'.'. ì \ . \ : '\ \ " , ....' \'\',- V'':' '-. ~ "'. ,- .~\.. \~... ....\.. ~ '\ \. ~.~ . ", \. . \ .. t -\ 1 . ~ -. ......., .........( 03VI303A ~ßQ! \ f 1:10 , ' J .vla .TAM SA.H ... "¡:, " . ',", ".'" - '\ .~~~,:.~., / \ -¡' ..'" .,. "~>,;..,'~ - ~/, - ~. " : /?y,'f¡ . · ~ /J6' 4IÞ BAKERSFIELD CITY FIRE DEPAR~ 2130 "G" STREET BAKERSFIELD. CA 93301 R E eEl V EO (805) 326-39f\79 ~~WJUL 20 1987 S«J :I~ '. Ans'd............ , . OFFICIAL USE ONLY ID# 305~:¿ IBUSINESS NAME , HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A ()()~16..\) INSTRUCTIONS: 1. To avoid further action. return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as ~ whole, 4. Be as brief and concise as possible. RECEIVED AUG 1 3 1987 Ans'd. ........... SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: BAKER~FTF.T.n VF.TF.RTNARY Hn~PTTAT TNr , B. LOCATION / STREET ADDRESS: 44,10 WIBLE .ROAD", CITY: Bakersfield CA ZIP',.. 9:i313 BUS. PHONE: (805) 834-,6005 SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1~800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. E~PLOYEES TO NOTIFY IN CASE OF E~ERGENCY: ~A~E AND TITLE DURING BUS. HRS. AFTER BrS. HRS. A. DR. TERRY M. SIPPEL, DVM Ph# 834-6005 Ph# 393-7315 B. DR. CYNTHIA L. MARTINEZ, DVM Ph# 834-6005 Ph# 872-0189 SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: N.E. Corner of Buildin£ on East Side B. ELECTRICAL: N. E. CORNER OF BUILDING - ON WALL - East Side C. WATER: Front of Bldg. North Side in Center next to Bld~. O. SPECfA~:- ~ E. LOCK BOX: YES /~ IF YES. LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? FLOOR PLANS? YES /7ÑfJ\ YE_S ,~ MSDSS? KEYS? YES YES ,~ W - 2A - e e " ¡.'~ ;"~~.J:-~~. ...... , . .::,z,> , " , SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE NO. SECTION 5: LOCAL EMERGE~CY ~EDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE MERCy/àøSRITAL EMERGENCY ROOM .... ;tor ".: 4, 2215 Trux~~~/t~fnue Bakersfield, "C'k 93301 CALL: EDWARD P. BROWN, M.D. Tel. 327-7348 2531 G Street Bakersfield, cA 93301 ; '. ~~: f SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL A~D REFRESHER TRAIXING IN THE FOLLOWING AREAS. CIRCLE YES OR NO A. METHODS"FÖR SAFE HANDLING OF HAZARDOUS :'-1ATERIALS: . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:..............:........... C. PROPER USE OF SAFETY EQUIPMEKT:.. . . . . . . . . . . . . . . . . D. EMERGENCY EVACUATION PROCEDURES:... . ... ...... .... E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:....... I:\ITIAL REFRESHER YES ~o YES ~o YES ~O YES NO YES :\0 YES NO YES :\0 YES NO YES NO YES NO SECTION 7: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: . . . ... YES NO I. TERRY M. SIPPEL, DVM , certify that the above information is accurate. I understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) aliâ that inaccurate information constitutes perjury. SIGNATURE TITLE SECRETARY DATE July 12, 1987 I. D. , KERN COUNTY FIRE DEPARTMENT FORM 4A-l page_ of II - NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY BAKERSFIELD VETERINARY HOSPITAL OWNER NAME: BAKERSFIELD VETERINARY BUSINESS NAME: WTRT.F. SMAT T ANTMAT H()C:PT'T'àT HOSPITAL. IN<FJ\CILITY UNIT .: ADDRESS: 4410 Wible Road ADDRESS: 323 Chester Avenue FACILITY UNIT NAME: CITY, ZIP: Bakersfield, cA 93313 CITY,ZIP:Bakersfield cA 93301 PHONE ,: ' 834-6005 PHONE ,: 327-4444 IOFF IC IAL USE CFIRS CODE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN ·THIS ~ BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE V)P 498 15,000 FT3 4 27 In Special Shed on Eas Oxygen d3Sq OXID Side of Bldº, --- ( Ii Ii -- --I - I; - I I II I' rjAME: WILFRED G. OWEN TITLE :OFFTC,F. MANAC:F.R SIGNATURE: EMERGENCY CONTACT: TERRY M. SIPPEL, DVM TITLE :Secretary OAT E : L:..l.2.-.ßL PHONE # BUS HOURS: 834-6005 AFTER BUS HRS: 393-7315 PHONE , BUS HOURS: 834-6005 AFTER BUS HRS: .JU.2-01 Rq HMCU-9 :1 [ ! [ ! I ,~MERGENtY CONTACT: CYNTHIA L. MARTINEZ, DVM TITLE: Veterinarian <,.' ~R I NC I PAL BUS I NESS ACT I V I TY: Full Service Small Animal Hogpi tal 'I ~~~ r----------'---'---------------- - ---,-,- ,- --- -- CONTAINER CODES -- ..---- . -_..._-~.:....._-- . -__ __,_,_~._~____ ._nn__~__.____ h...___ .: . TYPE CODES ¡ " -;; :~~~--'-"--b. ~~ " , , 01. Underground Tank 02. Aboveground Tank 03. Fixed Pressurized Tank 04. Portable Pressurized Cylinders 05. Insulated Tank (Includes Cryogenics) 06. Drums or Barrels Metallic Oi. Drums or Barrels - Non-Metallic 08. Carboy(s) 09. Glass Container(s) 10. Plastic Container(s) 11. Box (()s) 12. Bag(s) 13. Metal Containers (Not Drums) 14. In Machinery or processing equipment 15. Bin(s) 99. OTHER - Specify on separate sheet P = Pure M = Mixtures of pure ~ubstances W '" Wastes (Also add appropriate waste code) UNIT CODES LBS = Pounds TON II: Tons (2,000 lbs) GAL = Gallons BBL '" Barrels (42 ga ls ) Ft3 '" Cubic Feet CUR '" Curies USE CODES 01. Additive 23. Herbicide 02. Adhesive 24. Insecticide 03. Aerosol 25. Instructional 04. Anesthetic 26. Lubricant 05. Bactericide 27. Medical Aid or Process 06. Blasting 28. Neutralizer 07. Catalyst 29. Painting 08. Cleaning 30. Pesticide 09. Coolant 31. Plating 10. Cooling 32. Preservative 11. Drilling 33. Refining 12. Drying 34. Sealer 13. Emulsifier/Demulsifi~r 35. Spraying 14. Etching 36. Sterilizer 15. Experimental 37. Storage 16. Fabrication 38. Stripper 17. Fertilizer 39. Washing 18. Formulation 40. Waste 19. Fuel 41. Water Treatment 20. Fungicide 42. Welding Soldering 21. Grinding 43. Well Injection 22. Heating 44. Oil Treatment 99. OTHER-Specify on ~ZARD CODES EXPL - Explosive CMLQ - Combustible Liquid CMSL - Combustible Solid CRMT Corrosive Material FLGS - Flammable Gas FLLQ - Flnmmnble Liquid FLSI. .' Flammable So) id NFLG - ~on-Flammable Gas OG~X - Organic Peroxide OXr:J - Oxidizer CRYO - Cryogenics ORMA - Anesthetic, Irritant ORME - Hazardous Waste ORMS - Other regulated Material B.C,and D PSNA Poison A (Gas) PSNB - Poison B (Liquid or Solid) RADI - Radioactive WATR - Water Reactive ETIO - Etiological Agent PYRO - Pyrophoric, Hypergolic or spontaneously combustible ,~ e . .::¡ ---' ~"--»:,,......... .... / BAKERSFIELD CITY FIRE DEPARTME~T 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# ------ BUS INESS NMŒ: BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be rr:?turned by: 2, TYPE/PRI~T YOUR A~SWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. Wible Small FACILITY UNIT# Ani~ml Hn~ritK~CILITY UNIT NA~E: Bakersfield Veterinary Hospital, Inc. SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES ~ OG ~rr1f SECTION 2: NOTIFICATION AND EVACGATION PROCEDGRES AT THIS C~iIT O~LY See attached Fire Plan. 'u 3,\ - -- . SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Factlity Unit contain Hazardous Materials? . . , . , YES NO If YES I see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES ~o If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-l) If Yes, complete a hazardous materials inventory for~ mark~d: TRADE SECRETS ONLY (yellow form #4A-2) in addition tQ the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS SECTIO~ 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY, A. ~AT. GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, SITE PLANS? FLOOR PLA0:S? YES / NO YES / ~o :-ISDSs? KEYS? YES ;' '\0 YES I '\0 - 38 - '- , " .. ~_~;- J____; . . Business Name: Location: 0/ ¿¡ I D e, . Bakersfield Fire Dept. Hazardous Materials Inspection /3 A-/¿ €,rJ ß ¿" Ie! ¿u, 'b/f.. Date Completed ¿/~-I hOJP , .~. /0-//- 90 r~E(;E·§\rSD OCi 'j ? 1990 C>(!>C> 74.{ 0 Plan ID # 215-000 (Top right corner Business Plan) Station No. 7 Shift ~ Inspector f~! f: '"7 ~:!~ ¡~.l" ;,---:' n ¡ ÚJ. LL{~J4-5 .''''''" I:.'.." Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Material Comments: Adequate Inadequate ~ ~ ~ [S6" D o o D Verification ofMSDS Availability Number of Employees Verification of Haz Mat Training Comments: ~ o LJ D Verification of Abatement Supplies & Procedures Comments: D D / Emergency Procedures Posted Containers Properly Labeled Comments: Verification of Facility Diagram Special Hazards Associated with this Facility: FD 1652 (Rev. 3-89) ~ ~ D D D D £ White-Haz Mat Div. Yellow-Station Copy Pink-Business Office