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Home My WebLink AboutBUSINESS PLANi~~~ ,~~ "` THOMAS A BERRY DDS INC r~; _ 500__OLD RIVER _RD #255____ _ _ ~-~7~ 1 ~~a~ ~~ ~~oi' .t~~ .,~}~~ UNIFIED PROGRAM INSPECTION CHECKLIST ~' ~,~~~ 3~t '-'!'~'.-W?~,4V.4ft3rve:.:..... 7. r, .A+ ,.-. .s. ,~ -:,a _.., ...:..' '.~..:~,-.. ., z... .SECTION 1: Business Plan and Inventory Program '~ BASERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 5a ~ >7 n Fax: (661) 872-2171 FACILITY NAME NSPE TION DATE 2 NSPE ~IOJJ TIME ma 'TNo M~.S f ~ ~. Q i2.•. j y.~. ~ . Z„ ~ ® y, ADDRESS ~ O d ~ f~ ~ t li ~ ~ ~ ~~ ~ jOME NO•, ' `- u~ ~ O OF EM LOYEES FACILITY CONTACT ' ~ ~~ ~ ~ USINESS ID NUMBER 15_02, _ a, ` a, ~, 1 ~, 1 s .~ 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 ~~e ~Q G' ~ t /o >~ ~v ~ rti \~ ^~, . -^ BUSIrIt?SS PLAN CONTACT INFORMATION ACCURATE .~ ^ VISIBLE ADDRESS ~J ^ CORRECT OCCUPANCY O VERIFICATION OF INVENTORY MATERIALS ~~/~a , Y -~ ^ VERIFICATION OF QUANTITIES 1! 4~ ~1 ^ VERIFICATION OF LOCATION C~ ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES I~ ^ EMERGENCY PROCEDURES ADEQUATE [~ ^ CONTAINERS PROPERLY LABELED ~ ^ HOUSEKEEPING ^- ~ FIRE PROTECTION ~IC~ ; 51`_ . ~ 'I•'~ a~ e ~ r ,7 ~ e Q ^ SITE DIAGRAM ADEQUATE & ON HAND - _- ANY HAZARDOU+~S,.WASTE ON SITE? .Icil YES ^ NO EXPLAIN: x ~ Q~ _ ~ ~ ~~' `L ~1~ C r QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (861) 328-3979 ~ Inspector (Please Print) Fire Prevention / 1`~ In Shift of Site/Station # Rosins Sit hoot S' esponsible PaAy (Please Prht) White -Prevention Services Yellow -Station Copy pink - Buainesa Copy FD2019 (Rw. 02/05) a _ 4~`_ T~`" CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES ~' y UNIFIED PROGRAM INSPECTION CHECKLIST `k•Z,~4ti 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME 'I''Ko~as 13G ~sLy ADS yti c INSPECTION DATE ~/ Z~ ~~ 7 Section 4: Hazardous Waste Generator Program EPA ID # ^ Routine .~7 Combined ^ Joint Agency ^hulti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number 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 ,y Ignitable/reactive waste located at least 50 feet from property line ~" ~6 Secondary containment provided ~ Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste 0~ ~~ Proper management of lead acid batteries including labels ~ f ~ Proper management of used oil filters ~ /~ Transports hazardous waste with completed manifest ~~'~' ' b~- ~ ~ ~ s ~ 4 ~ / ° ^ Sends manifest copies to DTSC ~ ~ Retains manifests for 3 years ,~, `i~GO W~.~'..~ Retains hazardous waste analysis for 3 years > > Retains copies of used oil receipts for 3 years 6~ Determines if waste is restricted from land disposal ~,-~.vuip-~iu~VC v = v ~otaiton Inspector: Office of Environmental Services (661) 326-3979 ine Site sponsible Party White -Env. Svcs. Pink -Business Copy t4+- ' i i + BERRY DDS INC THOMAS A ______________________________ SiteID: 015-021-002129 + Manager Location: 500 OLD RIVER RD ,255 City BAKERSFIELD BusPhone: (661) 663-4451 Map 123 CommHaz Minimal Grid: 06B FacUnits: 1 AOV: CommCode: BFD STA 15 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title MARY BERRY / VICE PRESIDENT MONICA NEWBERRY / HYGIENST Business Phone: (661) 66.3-4451x Business Phone: (661) 663-4451x 24-Hour Phone (661) 319-1564x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact THOMAS A BERRY Phone: (661) 663-4451x MailAddr: 500 OLD RIVER RD 255 State: CA City BAKERSFIELD Zip 93311 Owner THOMAS A BERRY DDS INC Phone: (661) 663-4451x Address 500 OLD RIVER RD 255 State: CA City BAKERSFIELD Zip 93311 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: ~ Emergency Directives: ~ PROG H - HAZ WASTE GEN Based on responsible for obtaimn y °f those individuals under penalty of law9 the information, examined and That I have I Certify submitted and believe the n~forme nfo maaoln accurate, and complete. ation is true, . natt7F' .~-~ p`' date 3'~°\ 5~ G~p~~` 5~ ~~~PrJ ~ 1 i~ w 4~ ~f C DDB -1- 05/10/2006 ,~ :. ~. BERRY DDS INC THOMAS A Manager ~110!!ZC(~ ~ ~~~ ~~~s Location: 500 OLD RIVER R 255 City BAKERSFIELD CommCode: BFD STA 15 EPA Numb: BusPhone: Map 123 Grid: 06 SIC Code: DunnBrad: SiteID: 015-021-002129 (661) 663-4451 CommHaz Minimal B FacUnits: 1 AOV: Emergency Contact / Title Emergency Contact / Title MARY BERRY / VICE PRESIDENT MONICA NEWBERRY / HYGIENST Business Phone: (661) 663-4451x Business Phone: (661) 663-4451x 24-Hour Phone (661) 319-1564x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact THOMAS A BERRY Phone: (661) 663-4451x MailAddr: 500 OLD RIVER RD 255 State: CA City BAKERSFIELD Zip 93311 Owner THOMAS A BERRY DDS INC Phone: (661) 663-4451x Address 500 OLD RIVER RD 255 State: CA City BAKERSFIELD Zip 93311 ........... Period to TotalASTs: - Gal Preparers TotalUSTs: = Goal Certif' d: ~ RSs : No ParcelNo: ............. Emergency Directives: PROG H - HAZ WASTE GEN Based on my inquiry of those individuals onsible for obtaining the information, I certify res ENrD FEg p under penalty of law that 4 have personally ti 2 2 2 ~07 on examined and am familiar with the informa submitted and believe the information is true, accurate and complete. `~~`.~ ignature Date -1- Ol/26/2b07 F BERRY DDS INC THOMAS A SiteID: 015-021-002129 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit fc+ICP WASTE FIXER R L 4. 0 0 GAL Tt+In _2_ Ol/26/2b07 -3- O1j26/2007 F BERRY DDS INC THOMAS A SiteID: 015-021-002129 ~ ~ 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: X-RAY DEVELOPER CAS# Liquid TWaste -~mbRient~E ~ AmbientT~E I PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION "" Largest Container Daily Maximum I Daily Average ` 6.00 GAL 4.00 GAL ;-1.00 GAL COM _~~~~.~~J PONENTS $Wt. RS CAS# Silver No 7440224 ritit~tiRL L'iJ JL~J Jl•1P~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- O1/26/2b07 F BERRY DDS INC THOMAS A SiteID: 015-021-002129 ~ Fast Form~lt ~ ~ Notif./Evacuation/Medical Overall Sits ~ ~ Agency Notification 05/10/2046 ~ CALL 326-3979 Employee Notif./Evacuation 10/11/2046 THOMAS A BERRYS SECRETARY MAKE CALL. ASSISTANTS TO TOWEL-UP ANY SPILLAGE. t'UlJ11C: 1VVl.1L / r,VdC:Udl.lUil Emergency Medical Plan 01/27/2043 MERCY SOUTHWEST MEDICAL CENTER -5- Ol/26/~007 F BERRY DDS INC THOMAS A SiteID: 015-021-002129 ~ Fast. Form~:t ~ ~ Mitigation/Prevent/Abatemt Overall Sits ~ ~ Release Prevention 05/10/2016 ~ THERE IS AN AUTOMATIC DRAIN TO STORAGE CONTAINERS Release Containment 10/11/20176 THERE IS A VERY LIMITED POTENTIAL FOR ANY HAZARDOUS WASTE. THE FIXER DEVELOPER DRAINS VIA PIPE HOSE DIRECTLY INTO STORAGE CONTAINERS. THE MAXIMUM AMOUNT THAT DRAINS AT ANY TIME LESS THAN 1/4 PINT. ANY SPILLAGE IS CLEANED BY TOWELS. Clean Up 10/11/20176 JIMS X-RAY CLEAN-UP SERVICES REMOVE THE WASTE APPROXIMATELY ONCE A MONTH. JIM WOULD BE CALLED FOR ANY CLEAN-UP NECESSARY. THE MAXIMUM POTENTIAL FOR SPILLAGE IS A COUPLE OF TABLESPOONS. IF SPILLAGE DID OCCUR, TOWELS WOULD $E BE USED TO SOAK UP ANY EXCESS. Other Resource Activation -6- Ol/26/2b07 F BERRY DDS INC THOMAS A SiteID: 015-021-00212 ~ Fast Forma€ ~ ~ Site Emergency Factors Overall Site ~ .7~JCC;1dl riciGdIC1S V 1.1111.y iJ 11LL l..-V11.y' ~'JC~`~ f r~~C rLC~~ec:.~s-~vaii, water ~. , Building Occupancy Level 05/10/2005 6 EMPLOYEES -7- Ol/26/2~07 i. F BERRY DDS INC THOMAS A SiteID: 015-021-0021~~ ~ Fast Format ~ ~ Training Overall Side ~ ~ Employee Training 05/10/2006 ~ MSDS SHEET ON FILE BRIEF SUNIlKARY OF TRAINING PROGRAM: WE HAVE MEETINGS EVERY QUARTER TO DISCUSS: ACCIDENT PREVENTION, CLEAN-UP, EMERGENCY NUMBERS TO CALL, AND FOLLOW-UP. rc~yC ~ Held for Future Use Bela for r~uLUre use -8- O1/26/~007