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HomeMy WebLinkAboutBUSINESS PLAN~ PREFERRED FAMILY CARE PHYSIC _- -__ - 5925-A TRUXTUN EXTENSION t~ u ~ a !, ~s~ T. . 'C r PREFERRED FAMILY CARE PHYSICIANS Manager LORI BEACH Location: 5925 TRUXTUN AVE A City BAKERSFIELD SiteID: 015-021-002276 BusPhone: (661) 638-2273 Map 102 CommHaz Minimal Grid: 34A FacUnits: 1 AOV: CommCode: BFD STA 11 EPA Numb: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title JOHN T HEIDRICK DO / PRESIDENT RAJ A PATEL MD / SECRETARY Business Phone: (661) 638-2273x Business Phone: (661) 638-2273x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact JOHN T HEIDRICK- Phone: (661) 638-2273x MailAddr: 5925 TRUXTUN AVE A State: CA City BAKERSFIELD Zip 93309 Owner RAJ A PATEL MD Phone: (661) 638-2273x Address 5925 TRUXTUN AVE A. State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN J U L ~ Q ~4Q~` Based on my inquiry of those individuals res~~onsiiaie for nbtaining the information, I certify uncle? F-natty r; Saw that ! have personally examined and 3m familiar v~ith the information SiJt1F71itted aracf ~~el~c=~~e the information is true, acc~.r~ te, are' complete. ~ a ______ ~i ~ ~ ~ S ' i ~natur Date -1- 07/13/2007 :~ ~ aF `, F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 5.00 GAL Min -2- 07/13/2007 Y 'S -3- 07/13/2007 J -` : F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit Map: Grid: DARKROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWasteAmbient ~ Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL nt~~titcLUUa wrirulv~iv~l-5 %Wt. RS CAS# Silver No 7440224 t1E~GHKL A55L' S51~1L' 1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/13/2007 V ,_ 1% F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ Hl~. Ci1C:y 1VUL111C.:d1.1V11 Employee Notif./Evacuation _,_ , ,,-, rul.~il~.. l~vl..il_ . ~ l;va~uat.lvtl tlLllGll,. Clllry 1`1C lA1l:d1 rldll -5- 07/13/2007 i ;<S ~ F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention Release Containment Clean Up 02/27/2007 X-RAY SOLUTIONS AND SERVICE (REMOVAL DONE WEEKLY), 4700 EASTON DR 45, 637-0404. ~a~rdo ~ s ~r~o~+-:,J ~,vrc ir+ x • r~ c~-ac K rno~• V1,.11CL 1CCn7~UUL(.:C r-~c:~lvaLion -6- 07/13/2007 ~. ~f~ ,; F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~peciai riazaras Utility Shut-Offs 02/27/2007 UTILITY SHUT-OFFS OUTSIDE SE CRNR OF OFFICE. FIRE DEPT LOCK BOX WITH MAP AND KEYS TO THE RIGHT ABOVE ENTRY DOOR IN FRONT OF THE BLDG. Fire Protec./Avail. Water SPRINKLER SYSTEM AND FIRE EXTINGUISHERS. 02/27/2007 Building Occupancy Level 50-100 02/27/2007 -7- 07/13/2007 ,~J F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/27/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES RECEIVE TRAINING WHEN HIRED AND ALL EMPLOYEES RECEIVE INSTRUCTIONS ON VARIOUS ISSUES THROUGH AN ONGOING PROGRAM OF SAFETY MEETINGS HELD QUARTERLY. rciyC G Held for Future Use Held for Future Use -8- 07/13/2007 UNIFIED PROGRAM INSPECTION CHECKLIST ~ prevention Services B e a s F , „ 900 'I~ Llxtun Ave:, Suite 210 FARE Bakersfield, CA 93301 SECTION 1 : BuSin@SS Plan and Inv@IltOily Program aRrM Tel.: (661) 326=3979 Fax: (661) 872-2171 FACILITY ygME ~ INSPECTION DATE INSPECTION TIME ADDRESS ~2 > ~ ~ PHONE NO. t%~~ ~z273 NO OF EMPLOYEES - t'r5 FACILITY CONTACT D ~ ,~Lr K~ BUSINESS ID NUMBER 15-021- o 022?~j Section 1: Business Plan and Inventory Program ~~~ ®- ROUTINE ^ COMBINED ^ --- -, -_ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND I,~ ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS / ` ^ CORRECT OCCUPANCY ~ ^ VERIFICATION OF INVENTORY MATERIALS (~ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ~, ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (~ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING I~ ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # us' 'Si ponsible Party (Please Print) .White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 `. . ANY HAZARDOUS WASTE ON SITE? YES ^ NO r + PREFERRED FAMILY CARE PHYSICIANS ____________________ SiteID: 015-021-002276 + Manager Location: 5925 TRUXTUN EXT A City BAKERSFIELD BusPhone: (661) 638-2273 Map 102 CommHaz Minimal Grid: 34A FacUnits: 1 AOV: CommCode: BFD STA 11 SIC Code:8011 EPA Numb: DunnBrad: Emergency Contact J Title Emergency Contact / Title JOHN T HEIDRICK / DO RAJ A PATEL / MD Business Phone: (661) 638-2273x Business Phone: (661) 638-2273x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact Phone: (661) 638-2273x MailAddr: 5925 TRUXTUN EST A State: CA City BAKERSFIELD Zip 93309 Owner. Phone: (661) 638-2273x Address 5925 TRUXTUN EST A State: CA City BAKERSFIELD ~ Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ~ d: RSs : No Parcel.No Emergency Directives: PROG A - HAZMAT 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, {accu te, and c plete. 1 ~~ o ~ `~~'/ _ OlJ g ure Date -1- 03/13/2006 i" PREFERRED FAMILY CARE PHYSICIANS ~~ ~~Cal~@. SiteID: 015-021-002276 = Manager NOi~ ~ ~~~"~ ~ BusPhone: (661) 638-2273 Location: 5925 TRUXTUN EXT A Map 102 CommHaz Minimal City BAKERSFTELD Grid: 34A FacUnits: 1 AOV: CommCode: BFD STA 11 SIC Code:8011 EPA Numb: DunnBrad: Emergency Contact / Title _~~(r Emergency Contact / Title Se JOHN T HEIDRICK / DO ~~ '" RAJ A PATEL / MD Business Phone: (661) 638-2273x Business Phone: (661) 638-2273x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact ~ (j~t1 ~.1~`~~`C~, ~~ Phone: (661) 638-2273x MailAddr: 5925 TRUXTUN EXT A State: CA City BAKERSFIELD Zip 93309 Owner ~~~ ~ ~ Phone: (661) 638-2273x Address 59 TRUXTUN EXT A State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~ ~Nfi~ ~ ~~ ~ ~ 2AQ7 C ~zsed on my inquiry of those individuals responsible for obfiaining 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, and complP ~ tne7 s Signatur Date ~` -1- 02/06/2007 F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 5.00 GAL Min -2- 02/06/2007 -3- 02/06/2007 F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ .COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit Map: Grid: DARKROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste ~mbient ~ Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL nxatuct~vu~ 1~V1~lYV1V~1V1J %Wt. RS CAS# Silver No 7440224 nsic~ruct~ r~S~~J~l~i~lyla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/06/2007 F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification P~IllY1VyCC 1VlJ1.11 / rJVdl:LLdl.1Ul1 _ ~ i,-. t 113.!1 i1. 1VV L11 ~ L' V0.VU0.L11l11 1J LLlGlyGlll.y 1.1G t11~.0.1 x10.11 -5- 02/06/2007 1~ • '! F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention Release Containment dean up 1s X c S-o\~~;~s cz.~ rJ1 ~- .(~E~c~la-` ~i ~ - -e~~-~-( ~i.ec~t7 1.P3~1 - o~ny- ~,_ v~,iici iccavutt_.c Y1~:l.1VQl.1V11 -6- 02/06/2007 -~ F PREFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _, .~~c~.iai nac.aiu~ Utility Shut-Offs ~:~'z~ 1 i ~~v.c.-~ ~~ G..t'Q tv~c.~ bi.~-5 ~d~ ~ S~z~-~c-~" ~r~e.~ C~ -~-~. Y o~ -~ ~~~ DU11u111y v~:c:uNdilC;y bevel fn/lGc-1~1 tru ~ p c c ~- q ~ ~ , r--~ ~ ~ p ~ -7- 02/06/2007 f~ ~. ~ ~Y/ J F REFERRED FAMILY CARE PHYSICIANS SiteID: 015-021-002276 ~ Fast Format ~ Training Overall Site ~ Employee Training., ',-tv~~~0~-~5 Y-~Ce.J~. ~YG.-~~I'~~ ~ t~~'`Q"v~ ~-r-~G'~ Cs~-~. C~,l (v-~ ~O~(P~.S r_>r~-,c~~,r,~, ~- ~a~~ ifv~eR.-~-~ 1~S c,~.-~i~ rctyC L Held for Future Use Held for Future Use -8- 02/06/2007 ITE DUGRAM ~~ FACILITY DIAGRAM ~~ ' Business Name: Busiaess Address: Preferred Family Cate Physicians (A Medical Corporation) 5925-A Truxtun Extension Bakersfield, CA 93309 ~, ~~ ~~~~ .1 N .~ ~ 4 JOHN T. HEIDRICK, D.O. RAJ A. PATEL, M.D. Family Practice Internal Medicine REGINA A. NG, M.D. HEMMAL S. KOTHARY, M.D. Family Practice Family Practice. .~--^-~ i PREFERRED FAMILY CARE PHYSICIANS Medical Corporation By Appointment Only 5925-A Truxtun Extension Office (661) 638-CARE (2273 Bakersfield, CA 93309 Fax (661) 638-2281 j JOHN T. HEIDRICK, D.O. RAJ A. PATEL, M.I Family Practice Intemal Medicin PREFERRED FAMILY CARE PHYSICIAN 1 Medical Corporation I 6001-D, Truxtun Extension By Appointment Only Suite # 400 Office (661) 638-CARE (2273 Bakersfield, CA 93309 Fax (661) 638-228E ;â' . PREFERRED FAMILY CARE PHYSICIANS Manager : Location: 5925 TRUXTUN EXTENSION A City . BAKERSFIELD ComrnCode: BAKERSFIELD STATION 11 EPA Numb: . SiteID: 015-021-002276 . 1..~~~ ~ '\.~ ~ BusPhone: Map : 102 Grid: 34A (661) 638-2273 ComrnHaz : FacUnits: 1 AOV: SIC Code:8011 DunnBrad: Emergency Contact JOHN T HEIDRICK Business Phone: 24-Hour Phone : Pager Phone : / Title / D.O. (661) 638-2273x ( ) - x ( ) - x Hazmat Hazards: Contact : MailAddr: 5925 TRUXTUN EXTENSION A City : BAKERSFIELD Owner Address : 5925 TRUXTUN EXTENSION A City : BAKERSFIELD Period : Preparer: Certif'd: ParcelNo: to Emergency Directives: Emergency Contact / Title RAJ A PATEL / M.D. Business Phone: (661) 638-2273x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x React - Phone: (661) 638-2273x State: CA Zip : 93309 Phone: (661) 638-2273x State: CA Zip : 93309 TotalASTs: = TotalUSTs: = RSs: No Gal Gal \ tþ~ú.C \.r, ID© hswsb~ e®U'Îå~ ~h~~ ~ Û1avS ~, 1-..0 \ ) (TV~ ct çr!nt name . . "", {>/';'"" B1006\I1">b1rad h~taìrd©u$ m2~sn~l~ moo~@®o raVi~WSy ~u U>e <&2\~~~""'. ' '(r::e..(led ~d fo N\.O;;¿ . . \n ~ !an ~©U'çlÁ5f~ ~~I·(..ù::i )®OO ~M~ ß~ ®]©ú"I~ wW msrn~ \}ì) (\IJc!rn$oi urnnøro) any COIT{ê)(dlß©)i'ìJ$ ©©!I1$~~U~~ ~ (G©)mpl®1t® ~V\I©1 OOi'r~ Mtalfù- ~@smsrnt pi~iÏ! ~©U' my ~tð!~m~. h4v.' Þ-e~~~ Si(;nalUtE) -1- 09/26/2003 - - (!) FACILITYNAME~ ~LYCM.& ¡JADDRESS S1~~k \'U ><..'(VVV G'K. t- FACILITY CONTACT _ 'ì)l?- JotttJ fkEt oRt(1(.. INSPECTION TIME CITY OF BAKERSFŒI.J!) FIRE DIE!? ARlfMENT OFFICE OF ENVIRONMIJENlf AIL SERVICES UNIFIED PROGRAM HNS1PJEClI'HON CHECKLIST 1715 Chester Ave., ,3rd IF~l{)orr, JB2IIk~rs1field, CA 93301 INSPECTION DATE l ðf ( Jr lo'L PHONE NO. 01~ - '2..273 BUSINESS ID NO. 15-21 0- ~ NUMBER Of EMPLOYEES Sectio1l1l I: Business Plan and Inventory Progl1'2ImID o Routine o Combined o Joint Agency OJ Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS Appropriate pennit on hand N'C~ PC~( r s;. IE Business plan contact infonnation accurate Visible address Correct occupancy Verification of inventory materials ~ TE- F,'foGt... . (' ZS'O ~/f(tL) Verification of quantities ç- 6At... Verification of location tAJ!.(f')G- ()~ (lIh. Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any !IIlazarcrious waste on site?: ~es 0 No Explain: ~ ~ Fc;>c.lÁ:... Questions regarding this inspection? Please call us at (661) 326-3919 While· Env. Svcs, Yellow· Station Copy Pink - Business Copy Inspector: ~-VC~ e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME Pl~<f~ ~4..V CMX INSPECTION DATE u;-I (~I 0'2-- ~!~ Section 4: Hazardous Waste Generator Program EP AID # o Routine ~ Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Hazardous waste detennination has been made NL 1'7'C~~ ðr¿ EP A ID Number (Phone: 916-324-1781 to obtain EP A ID #) Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided 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 (J ~ Inspector: ur~> Office of Environmental Services (661) 326-3979 B¥1ness Site Responsible Party White - Env, Svcs. Pink - Business Copy - CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENViRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 /01-3</4 / Ie INSPECTION DATE '7 it 1...(0<- ¡v/~ FACILITY NAME f'Key:6«ZGô ~ ~ c.fJIl.é, f4iyJ$- Section 4: Hazardous Waste Generator Program EP AID # tí:. Routine 0 Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Hazardous waste deteffiÚnation has been made > (';.At- ~1'G f; )C.C<?- (OM.~ ~ EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) N/A Authorized for waste treatment and/or storage WtL.L.- $C"""'Þ p~t r p.;>ft..(CfirytCIt'J 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 Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal C=Compliance Inspector: Office of Environmental Services (661) 326-3979 White - Env. Svcs, W /ðv0 0ffiù V=Violation Pink - Business Copy · /lmlJ)f 11-/110/7 .J ~ 85001 3'ff!Ò CITY OF BÄKERSFIEIJ) ]FIRE !l)EP ARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM llNSPIECTHON CHECKLIST 1715 Chester Ave" 3rd I~'noor, Bakersfield, CA 93301 Section 1: FACILITY NAME ?R6f"~~.J) ~tc..Ý Cß(té A#s... INSPECTION DATE g ( '3 Ie 1 ADDRESS ~ÐOl- D ~,,~ :tt.40ò PHONE NO, ~3~ - '2-"2..n FACILITY CONTACT ~ f{601t.1(t( 4 p/)..~ BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER Of EMPLOYEES /ð23Y A- gðl/ o Complaint 1/ Business Plan and Inventory Program o Routine ,Øcombined o Joint Agency o Multi-Agency ORe-inspection OPERA TION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Veri fication of inventory materials ~æ FV'C4- Verification of quantities .s:- é ...Ai.- Verification of location (N<;.,f)Ç p ~ tZ.IV'\ 'Sw C(l.v{L õI=- 6"-06- Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste Qß site?: aVes 0 No Explain: WA-5æ r--l~-«- ~ Pink - Business Copy /fJ1 ~,fk(k Business Site Responsible Party Inspector: W 11...Jt25, Questions regarding this inspection? Please call us at (661) 326-3979 White - Env, Svcs, Yellow - Slalion Copy .' -, /-/1'?70;f/ . ;///]6/ 7 .J ~ S5()O! 3'ff(!() CITY OF BAKERSFIEIJD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Hoor, Bakersfield, CA 9~301 FACILITY NAME ~c;r"-~..t) ~I~"¡ c.PN£ 0#$... INSPECTION DATE g I'S ¡{; ~ ADDRESS ~OOQ = C 1"«¿Ú¡!"j'V.rJ 2Æ.40@ PHONE NO. ~~~... 2- 'Z:r~) FACILITY CONTACT 1t'v;; C4((;.OItI(!{ II ?A~ BUSINESS ID NO. 15-210- INSPECTION TIME ' NUMBER OF EMPLOYEES /()2.3t.¡Â- gð¡¡ o Complaint ., " II Section 1: '¡., Business Plán and Inventory Program .., o Routine Ø£ombined o Joint Agency o Multi-Agency ORe-inspection OPERATION C V COMMENTS Appropriate pennit on hand Business plan contact infonnation accurate Visible address Correct occupancy Veri fication of inventory materials ~}fë F~~ Verification of quantities _r (" ....Afb Veri fication of location vNJS,, )(; O~ ~ <w Cn.vfL eN=- ß....Q('" Proper segregation of material V erification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures .. Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: UYes 0 No Explain: WA511E. r-:-I~~ ~ White - Env. Svcs, Yellow - Station Copy Pink - Business Copy --111~·'.~,V:ja Business Site Responsible Party Inspector: W~~ / PI /' Questions regarding this inspection? Please call us at (661) 326-3979 " · CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ,FACILITY NAME 'P(t[.(-~ ~If_'i <2fVl.Z A~lCllWS INSPECTION DATE ~h/01 ( Section 4: Hazardous Waste Generator Program EP AID #L:AL 060 17'147 I o Routine Ø-Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Hazardous waste detennination has been made EP A ID Number (Phone: 916-324-1781 to obtain EP A ID #) Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided 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 '-i/¡!calr. þt¡l. Inspector: W lAJC-5 Office of Environmental Services (661) 326-3979 White - Env, Svcs. Business Site Responsible Party Pink - Business Copy / . . PREFERRED FAMILY CARE PHYSICIANS FIRE/DISASTER EVACUATION PLAN ~ YOU ARE HERE j ï-.J l'! \. ,I W' I I r 1: IJ ' II . . J ~ 1 r' ",; ." . 1'--- e . l.rai' ;a-¡ J./ II ~ /I . .ñ 'TE 4tOO AREA I I 1 ( , (_4_ ¡ ~ .. I -L I 'I e- .. ,.~ I! t,J1 L l~~ ! ~ a r-.~ ~ r. J ! b.l J ¿îF\sttrll , I ~ \ 1 F~".....) ,f II ....... II e I ~ fi ,- '\. H . ~ LEGEND: I Exit Fire Extinguisher