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HomeMy WebLinkAboutBUSINESS PLANAndrew A Pounds ~~5 Inc - - - I 2320 17th St -- - ~ ~; - - - - - ;, Prevention Services UNIFIED PROGRAM LNSPECTt~iV CHECKLIST A F ~ S F , , n 900 Truxtun Ave., Suite 210 ~~~ ~,_~~. 9~ .~.-~ ~.~ ,.~.- ~_. M ~. ~_,~ ~ ~ ~ae__ ___- ..~._m~. ~ ~__ _.--~~~ ~, FIRE ~ ~ Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program "'~'"' r Tel.: (661) 326-3979 Fax: (661) 872-21.71 FACILITY NAME ~ - //J~ INSPE TIryON~DATE ~ INSPECTION TIME ~~ ~ h l~(/ v / ~~. ~ ADDRESS ~~ PHONE NO. NO OF EM LOYEES ~ ~~ 2~ i~ ~9s3r~-._s FACILITY CONTACT BUSINESS ID NUMBER 15-021-01,$ - l:J ~i j - Section 1: Business Plan and Inventory Program ^ ROUTIN~COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ 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 ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? -YES ^ NO EXPLAIN: `~ G"`Sa e ~~ u - r~~ I QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~.~~~-,tz,__ Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # - White -Prevention-Services- Yellow -Station Copy Pink -Business Copy - ~ FD 2155 {Rev. 09/05 yT ~~ v ~0¢~` `r~'`~ CITI' OF BAKERSFIELD FIRE DEPARTMENT w ~ OFFICE OF ENVIRONMENTAL SERVICES ~' ~" I3NIFIED PROGRAM INSPECTION CHECKLIST _;~~gti ~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~p ~"fl S D ~ S INSPECTION DATE LI / 2 `~ l d 7 Section 4: Hazardous Waste Generator Program ^ Routine l~ Combined ^ Joint Agency EPA ID # ~: x ~ -..P ~"fi ^ Multi-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~x ~ „„ Ip r- 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 oii filters ,~ Transports hazardous waste with completed manifest Sends manifest copies to DISC Retains manifests for 3 years ~b ~ la-S d N Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years 1V~ Determines if waste is restricted from land disposal C=Compliance~+ ~jV~,=Violation Inspector: C..,/.Y ~~~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. Business Site Res nsible Party Pink -Business Copy ~ ~\ '~}ti..M 11~~~~F, POUNDS DDS INCg ANnDR(E~W A = Manager ~~DC(,~, t~ • f~ ~ ~~ Location: 2320 17TH ST City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: SiteID: 015-021-002283 ,% BusPhone: (661) 395-3115 Map 102 CommHaz Minimal Grid: 25D FacUnits: 1 AOV: SIC Code:8021 DunnBrad: ,_. Emergency Contact / Title 1 Emergency Contact / Title LINDA POUNDS / ~ ~ Q • ~ / Business Phone: (661) 395-3115x f Business Phone: ( ) - x 24-Hour Phone (661) 395-3115x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact LINDA POUNDS Phone: (661) 395-3115x MailAddr: 2320 17TH ST State: CA City BAKERSFIELD Zip 93301 Owner ANDREW A POUNDS DDS ~~~ Phone: (661) 395-3115x Address 2320 17TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN Daed on my inquiry of those individuals responsible #or obtaining the information, I certi#y under penalty ofi 18N1 that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~~1 '~/ V ~ nature Date '~N~`' ' g -1- 02/06/2007 ~ _ t° v F POUNDS DDS INC ANDREW A SiteID: 015-021-002283 ~ ~ 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 1.00 GAL Min ~ 9~ ~i/r^ -2- 02/06/200 ;v_'_ .. ,,,~ `~ ~ F POUNDS DDS ING ANDREW A SiteID: 015-021-002283 ~ ~ 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 TWaste -~mbient ~ Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum D~xl~ly Average 1.00 GAL 1.00 GAL 1.00 GAL HAZARDOUS COMPONENTS Silver No 7440224 tl.".GHKL 1jJ~~a51~11";1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA .USDOT# MCP No No No No/ Curies R / / / Min -4- 02/06/2007 F POUNDS DDS INC ANDREW A SiteID: 015-021-002283 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ 1<c1cdCC rLCVC11L1V11 = - ~ AC LCQw7C l.Vll l..d LlllllCll•l. glean up (~1'1 ~ ~ .~, bYi U'~/fi7 a,~ (~ j x~ ~r• V1.11CL iCCw7VULl.:C a`il:LlVdl.lUi1 -6- 02/06/2007 ;`y ~ ~, ~ r+ r F POUNDS DDS INC ANDREW A SiteID: 015-021-002283 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ o~c~:iai na~atu~ n G~al~rpo~F ~~k i~o~~ fink ~ ~~~~ Building: Occupancy-Level s~ ~io~ ~~. S~~ b iay) -~- 02/06/200 y ;~. ~ ~ '~ ~, F POUNDS DDS INC ANDREW A SiteID: 015-021-002283 ~ Fast Format ~ ~ Training Overall Site ~ .Employee Training ~._ Qs N ~A ~ ~~ ~I 1J,,~daw Mal*n~-nls, ~U sl~(f a~`'(.~6 rayC ~ neia =or ruLUre use nCiu tvi ruLUi~ V5C -8- 02/06/2007 f POUNDS DDS Manager Location: City INC ANDREW A _____________________________ SiteID: 015-021-002283 + 2320 17TH ST BAKERSFIELD BusPhone: (661) 395-3115 Map 102 CommHaz Minimal Grid: 25D FacUnits: 1 AOV: CommCode: BFD STA Ol SIC Code:8021 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ~ LINDA POUNDS / / Business Phone: (661) 395-3115x Business Phone: ( ) - x 24-Hour Phone (661) 395-3115x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React ',- - --" -- Contact ` c ^LINDA -POUNDS - __ ~ ~ ' - - - - _ ~ - '~ - - ~ - ~ ~ Phone : (6 61) _ - 3 9 5 - 3115x ~- ~ - MailAddr: 2320 17TH ST State: CA -City BAKERSFIELD Zip 93301 Owner ANDREW A POUNDS DDS Phone: (661) 395-3115x Address 2320 17TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: _ ~ .Gal Certif'd: ~ ~- RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ENT'D JUN 2 8 2006 Based on my inquiry of those individuals responsible fior 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, acc rate, and com lets. rr~/ - ~ S ure - Date V(d -------------------------- -1- 05/22/2006 ~~ POUNDS DDS INC ANDREW A Manager LINDA S POUNDS Location: 2320 17TH ST City BAKERSFIELD SiteID: 015-021-002283 BusPhone: (661) 395-3115 Map 102 CommHaz Minimal Grid: 25D FacUnits: 1 AOV: CommCode: BFD STA 01 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title LINDA S POUNDS / VICE PRESIDENT / Business Phone: (661) 395-3115x Business Phone: ( ) - x 24-Hour Phone (661) 395-3115x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact LINDA S POUNDS Phone: (661) 395-3115x MailAddr: 2320 17TH ST State: CA City BAKERSFIELD Zip 93301 Owner ANDREW A POUNDS DDS INC Phone: (661) 395-3115x Address 2320 17TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN inquiry of those indi'' Ce~.'fy n i CIV~~ o , Lased on my the informat ersonally r obta.ning e p f QC ~ o 4 sibie resp`'n under penalty cyf lave that 1 hav familiar with the information is true, ~©© the information xamined and am / e submitted an co li the acc~ te, and O (7 7j ~1 Date S n ure -1- 10/02/2007 7 `ti F POUNDS DDS INC ANDREW A SitelD: 015-021-002283 ~ ~ 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 ~ 1.00 GAL Min ~~~~~ ~~ ~~~~~~~z~-. -2- 10/02/2007 -3- lOf 02/2007 a F POUNDS DDS INC ANDREW A ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit DARKROOM SiteID: 015-021-002283 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# Liquid TWaste ~Ambient~E ~ AmbientT~E l~STOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container ~~ .D~..i~y Maximum D ~ly Average 1.00 GAL ~ 1.00 GAL ~ 1.00 GAL t1E~G1-~ttLV U 5 l: V1~lY V1V 1;1V l %Wt. RS CAS# Silver No 7440224 rlt~~r~tcl~ ti~5~~~l~irlvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 10/02/2007 r, F POUNDS DDS INC ANDREW A SiteID: 015-021-002283 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ HyClll:y 1VV1.111Ud1.1V11 Employee Notif./Evacuation ,~ t l.l.l.l1 l V 1V V L 11 ~ L~ V 0.l. 1.L0. L 1 V11 PrlllCil~Clll:y 1"1C U1l: CL1 t'1d11 -5- 10/02/2007 F POUNDS DDS INC ANDREW A SiteID: 015-021-002283 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/24/2007 ~ SECONDARY CONTAINMENT Release Containment SECONDARY CONTAINMENT 04/24/2007 Clean Up 04/24/2007 PATTERSON DENTAL ENVIRONMENTAL CARE PICK UP. CALL FOR LARGE SPILLS. Other Resource Activation -6- 10/02/2007 ~, r, F POUNDS DDS INC ANDREW A SiteID: 015-021-002283 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7tl C l:lQl nClG Cif u~ Utility Shut-Offs 04/24/2007 GAS: N SIDE OF BLDG ELECTRICAL: N SIDE OF BLDG WATER: N SIDE OF BLDG Fire Protec./Avail. Water 02/27/2007 FIRE EXTINGUISHER AND SINK WITH FAUCET IN DARKROOM Building Occupancy Level 04/24/2007 8 EMPLOYEES -7- 10/02/2007 d° -. r F POUNDS DDS INC ANDREW A SiteID: 015-021-002283 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/27/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM; OSHA STANDARDS FOR ALL HAZMAT. ALL STAFF QUALIFIED. rayc c izciu Lvi r u~.uJ..c v5c raciu tvi r ul.uLC V5C -8- 10/02/2007