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Home My WebLink AboutBUSINESS PLAN 2000ADVANCED CHIROPRACTIC SiteID: 015-021-001670 Manager : BusPhone: (661) 323-6857 Location: 5300 CALIFORNIA AVE 340 Map : 102 CommHaz : Minimal City : BAKERSFIELD Grid: 34D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 11 SIC Code:8041 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title STEVE SALYERS / OWNER GREG HEYART / CO OWNER Business PhOne: (661) 323-6857x Business Phone: (661) 327-2622x 24-Hour Phone : (661) 327-7074x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: React Contact : Phone: (661) 323-6857x MailAddr: 5300 CALIFORNIA AVE 340 State: CA City : BAKERSFIELD Zip : 93309 Owner STEVE SALYERS Phone: (661) 323-6857x Address : 5300 CALIFORNIA AVE 340 State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: -1- 06/16/2003 f ADVANCED CHIROPRACTIC SiteID: 015-021-001670 ~ Hazmat Inventory By Facility Unit -- MCP+DailyMax Order Fixed Containers at Site Hazmat Common Name... SpooHazlEPA HazardsI Frm DailyMax IUnitlMcP WASTE FIXER R L 5.00 GAL Min 2 06/16/2003 ADVANCED CHIROPRACTIC SiteID: 015-021-001670 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site WASTE DEVELOPER & FIXER SOLUTION 365 Location within this Facility Unit Map: Grid: CAS# r STATE ~ TYPE i PRESSURE i TEMPERATURE CONTAINER TYPE Liquid /Waste Ambient Ambient PLASTIC CONTAINER ~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL HAZARDOUS COMPONENTS %Wt. - .... ' .......... '-~NRS:Io I .... CAS#- Silver 7440224 HAZARD ASSESSMENTS ! TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# I MCP No N° No No/ Curies R / / / I Min MISC. LOCAL AGENCY DATA Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag. Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Definedg: Ag.Definel0: -- Ag.Definell -3- 06/16/2003 ADVANCED CHIROPRACTIC SiteID: 015-021-001670 = Inventory Item 0001 Facility Unit: Fixed Containers at Site WASTE DATA Treated On Site I CA C°deNo US Code GAL Generated/Mo.I GAL Generated/Yr. Treatment UnitID: Unit Type: Agency-Defined Text Label -4- 06/16/2003 F ADVANCED CHIROPRACTIC SitelD: 015-021-001670 Fast Format = Notif./Evacuation/Medical Overall Site --Agency Notification 12/11/2000 3X DAILY VISUAL CHECK OF FIX SOLUTION TANK & TRAY FOR LEAK. -- Employee Notif./Evacuation 12/11/2000 DR SALYERS (OWNER), CALL 326-3979 OES AND XRAY SOLUTIONS AT 637-0404. Public Notif./Evacuation 12/11/2000 NOTIFY DR SALYERS, CALL XRAY SOLUTION CO 637-0404. Emergency Medical Plan 12/11/2000 NO EMPLOYEE MAY TOUCH CHEMICALS. WASH WITH SOAP AND WATER IS EXPOSURE OCCURS AND REPORT TO DR SALYERS. GO TO MERCY HOSPITAL IF CONTAMINATED. -5- 06/16/2003 ADVANCED CHIROPRACTIC SiteID: 015-021-001670 Fast Format = Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 12/11/2000 LEAVE TANK IN 5 GAL TRAY. IF SPILL IS CONTAINED IN TRAY LEAVE ALONE AND CALL XRAY SOLUTION 637-0404. IF NOT CONTAINED CALL FIRE DEPT 1ST AND XRAY SOLUTION NEXT. THIRD CALL 326-3979 OES. -- Release Containment 12/11/2000 CONTAINER COLLECTED EVERY 6 MO OR SOONER IF NEEDED. NO MORE THAN 5 GAL ON PREMISIS AT A TIME. TANK TO BE LEFT IN A WATER PROOF TRAY AT ALL TIMES. -- Clean Up 12/11/2000 CALL XRAY SOLUTION 637-0404. Other Resource Activation -6- 06/16/2003 ADVANCED CHIROPRACTIC SiteID: 015-021-001670 Fast Format ~ Site Emergency Factors Overall Site Special Hazards -- Utility Shut-Offs 12/11/2000 A) GAS B) ELECTRICAL- C) WATER - D) SPECIAL- E) LOCK BOX - Fire Protec./Avail. Water 12/11/2000 PRIVATE FIRE PROTECTION - (IE. FIRE EXTINGUISHERS OR SPRINKLER SYSTEM?????) NEAREST FIRE HYDR3ANT - (LOCATION?????????) IBuilding OccupanCy LeVel I -7- 06/16/2003 ADVANCED CHIROPRACTIC SiteID: 015-021-001670 Fast Format ~ Training Overall Site -- Employee Training 12/11/2000 WE RAVE 2 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE IN OFFICE DARK ROOM. BRIEF SUMMARY OF TRAINING PROGRA_ivI: EMPLOYEES NOT ALLOWED TO CLEANUP UNDER ANY CIRCUMSTANCE. -- Page 2 H~i~ ~or~t~e Use --'-'-----'~ I Held for Future Use I 8 06/16/2003 ENTRANCE STORAGE 1 ,~'~/2/~U~ ~~/I/ ~ ~, RECEPTION ~ ~ ~{~~ WAITING FILES ~ ~ ~ ~ T'c T. Ci[ -- - ~ - , R~A, Id~N- I :v:~r: RM ~ STOR ~ v p~,v 2 EXAM _ OFFICE i CONSULT TO LE~ = :~' ~ ~: ~- HOUSE'OF MANNA i~.{~i-t~--~VF~'i SiteID: 015-021-001722 Manager ~\ 00~k~ JULY5 2000 BusPhone: (805) 633-5322 Location: 5300 CALIFORNIA A~Ej.~i~ ~ ~ I Map : 102 CommHaz : Moderate City : BAKERSFIELD lBY. ~.' I Grid: 34D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 11 SIC-Code: EPA Numb: DunnBrad: Emergency Contact / Title ~mer~ency uonnacn / Title TONY ALVAREZ JR /MANAGER C~lo ~~ ~ Business Phone (~,~)~ 633-5322x Business Phone: (:~*%_0) 633-5~~ 24-Hour Phone : ;6~/ 872-7942x 24-Hour Phone : Pager Phone : (~{)5~q-~07.x Pager Phone : (~%)~- ~x Hazmat Hazards: Fire Press ImmHlth Contact : ~%K~O[~%~ Phone: (~ MailAddr: 5300 CALIFORNIA AVE 200 State: CA City : BAKERSFIELD Zip : 93309 Owner PACIFIC HEALTH EDUCATION CENTER Phone: Address : 5300 CALIFORNIA AVE 200 State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: ' RSs: No Emergency Directives% = Hazmat Inventory One Unified List -- As Designated Order Ail Materials 'at Site Hazmat Common Name... ISpeoHazlEPA HazardsI Frm I DailyMax UnitlMcP PROPANE F P IH G 385.00 FT3 Hi HELIUM~~'^\~/~ -~%~7.~D F P IH G 250.00 FT3 Min I, ~ o hereby certify ~hm I have ~y~ or p~nt ~) ~ ~. reviewed ~he a~hed h~a~ous mmeHals ma~age- .mere plan ~or.~. ~ ~U and ~hm it along wi~h (Na~ of . · 'anycorre~io2sconsti~utel:3~ete__..,_~,/.~ and corre~ man- ' agemem pla3 fo~~.~ 07/~/2000 HOUSE OF MANNA SiteID: 015-021-001722 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~U~vIU~ ~vJ~ / ~l~-.~.J-~ ~Vl~ PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHWEST OF CORNER PARKING LOT. CAS# 74-98-6 Gas /PureIi Above Ambient Ambient FIXED PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average FT3 385.00 FT3I 200.00 FT3 HAZARDOUS COMPONENTS %Wt. RS] CAS# 100.00 Propane Yes 74986 HAZARD ASSESSMENTS TSecretl ~SlBi°HazNo N No Radi°active/Am°unt I EPA HazardsINo/ Curies F P IH NFPA ~/// USDOT# MOP Hi ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site 9 -- COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 7440-59-7 F STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas /Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 250.00 FT3 250.00 FT3I 250.00 FT3 HAZARDOUS COMPONENTS %Wt. ~S CAS# 100.00 Helium N 7440597 ~ HAZARD ASSESSMENTS I I S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F P IH / / / Min 2 07/14/2000 F HOUSE OF MANNA SiteID: 015-021-001722 I Fast Format ~ Notif./Evacuation/Medical Overall Site -- Agency Notification 01/29/1996 TELEPHONE AVAILABLE INSIDE STORE AND A PAY PHONE IS LOCATED OUTSIDE BETWEEN HOUSE OF MANNA AND THE IRS OFFICE. 0 /29/1996 Employee Notif./Evacuation CELLULAR PHONES AVAILABLE FOR OUTDOOR USE BETWEEN PROPANE TANK AND STORE. -- Public Notif./Evacuation : 01/29/1996 TANK IS LOCATED IN PARKING LOT AREA AWAY FROM STORE AND IN ISOLATION OF VEHICLE TRAFFIC. Emergency Medical Plan 01/29/1996 FIRST AID KITS ON SITE. SAN JOAQUIN HOSPITAL. 07/14/2000 F HOUSE OF MANNA SiteID: 015-021-001722 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 01/29/1996 VALVES ARE LOCKED AN HOSE SECURED BEHIND GATE ON TANK WHEN NOT IN USE. --ReleaSe Containment 01/29/1996 TANKAREA IS PROTECTED BY GUARD POSTS. -- Clean Up 01/29/1996 N/A Other Resource Activation -4- 07/14/2000 HOUSE OF MANNA siteID: 015-021-001722 Fast Format ~ Site EmerHency Factors Overall Site -- Special Hazards 01/29/1996 NATURAL GAS/PROPANE: NATURAL GAS, OUTSIDE NORTHEAST CORNER OF BUILDING. ELECTRICAL: OUTSIDE N/W CORNER OF BUILDING. WATER: OUTSIDE SOUTHEAST CORNER OF BUILDING. SPECIAL: NONE LOCK BOX: NO ~ Utility Shut-Offs 01/29/1996 PRIVATE FIRE PROTECTION IS A FIRE EXTINGUISHER LOCATED BY PROPANE TANK. -- Fire Protec./Avail. Water Building Occupancy Level -5- 07/14/2000 HOUSE OF MANNA SiteID: 015-021-001722 Fast Format ~ Training Overall Site -- Employee Training 01/29/1996 NUMBER OF EMPLOYEES: 7 MATERIALS SAFETY DATA SHEETS ON FILE: ??? BRIEF SUMMARY OF TRAINING PROGRAM: SUBURBAN PROPANE PROVIDES CERTIFICATION FRO HANDLING PROPANE TO HOUSE OF MANNA EMPLOYEES. -- Page 2 Held for Future Use Held for Future Use 6 07/14/2000 O CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, C~ HAZARDOUS MATERIALS MA , 1. To avoid further action, return this form within 30 days of receipt. | 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner / Operator Form and Chemical Description Form(s) to the fi'ont of this plan instead of completing SECTION I. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA LOCATION: MAILING ADDRESS: · · STATE: ~ ZIP.'. ,, , PHO~NE: PR/~Y ACTIVITY: ,. -. ., ,, ,, EMERGENCY NOTIFICATION ~ "- CONTACT' u: >"~" TITLE" BUS. PHONE '" 24 HR. PHONE 1 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II. i: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: B. EMPLOYEE AND AGENCY NOTIFICATI01~: · C. ,.) ENVIRONMENTAL RESPONSE MANAGEMENT: D. EMERGENCY MEDICAL PLAN: HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: B. ' RELEASE CONTAINMENT,AND/OR MITIGATION: · -/o C. CLEAN-UP AND RECOVERY PROCED~JRES: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: ,~r~ ELECTRICAL: WATER: SPECIAL: , LOCK BOX: YES/NO IF YES, LocATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: ,~ .-Z..-- · MATERIAL SAFETY DAT.* SHEETS ON FILE: BRIEF' SUMNFARY (~F' TRAINING PkOGRAM: CERTIFICATION I, ~"~~~~ CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND SIGNATURE TITLE DATE 4 ~ CITY OF BAKERSFIELD~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER I OPERATOR IDENTIFICATION FACILITY INFORMATION Page Of FACILI~ID$ {~j~;~l~ ~1~,~t '.l~ q ._l 5J_ ~ YearBeginnina / ~ lOO YearEnding _~ / ~ / BUSINESS NAME (Same as FACiLI~ NAME or DBA- Doing Business ~) [ f ~ BUSINESS PHONE SITE ADDRESS ~o3 DUN & ~06 SIC CODE ~oz B~DSTREET (4 Digit g) COUN~ ~ t OWNER ~'LING J~ O ~ ~' ~ 1,3 ADDRESS CONTACT NAME ~~ ~ ~7 CONTACT PHONE 118 CONTACT ~ILING ADDRESS CI~ ~2o STATE ~2~ ZIP ~22 ~~ 123 NAME NAME ~ ~ T~TLE ~ ~~~ BUS~NESS PHONE ~2~ BUS,NESS PHONE ~ ~ ~ ~ ~ 24-HOU~ PHONE ~ ~ ~ ~ ~ ~2~ 24-HOU~ PHONE ~ ~ PAGE~ ~ ~8 PAGE~ ~ Ce~ifi~aon: Based on my inqui~ of ~ose individuals responsible for ob~ining the info~ation, I ~i~ under penal~ of law ~at I have personally examined and am ~miliar with the info~ation submiEed in this invento~ and believe the information is true, accurate, and complete. SIG~ IDATE/¢~/OO// 1~ NAMEOFDOCUMENTPREPARER~ ~ ~ 135 , N~E~F OWN~OPE~TOR ~fint) 136 TITLE OF 6WNE~OPE~TOR 137 UPCF (7~99) S:\CUPAFORMS\OES2730.TV4.wpd ~ CITY OF BAKERSFIELI~ ~~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 ' HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per matedal per building or ama) [] NEW [] ADD [] DELETE [] REVISE 200 Page __ of __ I BUSINESS NAME (Same as FACILITY NAME Business AS) 3 CHEM]CAL LOCATION ~"'~'-,~ CO ~~ fi** ~.-~'~ ~l~ =~ 201~ CHEMICAL LOCATION ~ No 202 ~ CONFIDENTIAL (EPC~) 205 T~DE SECRET ~ Y~ ~ No 206 CHEMICAL ~ME~ ~~ ~~ ~ F/~ ~ ~~ If Subj~ to EPC~, refer to ins~ions COM~N ~ME ~ ~~ tv ~ ~ ~7 EHS* ~ ~ y~ FIRE CODE H~RD C~S~S (~mplete if ~u~t~ by I~1 fire ~i~ 210 ~PE ~ p PURE ~ m MI~URE ~ w WASTE 211 ~DIOACTIVE ~ Y~ ~ No 212 FED H~RD CATE~RIES ~ I FIRE ~2 R~CTI~ ~3 PRESSUREREL~SE ~4 ACUTE H~LTH ~5 CHRONICH~LTH 216 (Ch~ all that apply) ANNUAL WASTE~/ 217 ~IMUM 218 A~GE 219 STATE WAS~CODE ~0 A~U~ ~~--~ DALLY A~U~ DALLY A~U~ ~ITS' ~ ga ~L ~ d CU ~ ~ lb LBS ~ tn TONS 221 DAYS ON SITE ~2 * If EHS, am~nt must be in lbs. STOOGE CONTAINER ~ a ABOVEGROUND TANK ~ e P~STI~NONMETALLIC DRUM ~ i FIBER DRUM ~S BO~LE ~ q ~IL CAR (Check all ~at apply) ~ b UNDERGROUND TANK ~ f CAN ~ j BAG ~n P~STIC BO~LE ~ r OTHER ~ c TANK INSIDE BUILDING ~ g CARBOY ~ k BOX ~ o TOTE BIN ~ d STEEL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WAGON STOOGE PRESSURE ~ a AMBIE~ ~ aa ABOVE AMBIE~ ~ ba BELOW AMBIE~ ~4 STOOGE TEMPE~TURE ~ a AMBIENT ~ aa ABOVEAMBIE~ ~ ba BELOW AMBIE~ ~ c CRYOGENIC 2 ~0 231 ~ Y~ ~ No 232 ~3 3 234 235 ~ Y~ ~ No 236 ~7 4 238 239 ~ Y~ ~ No 240 241 5 242 243 ~ Y~ ~ No 244 245 UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd