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Home My WebLink AboutBUSINESS PLAN 3/31/2007 h _O ~U ~ ~ ~ ~ F7 ~ ~?S N d ~ ~ '~ O m C i d Y i :, ~ ~~ ~ _ - F~E-R~VBONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~' -~ Manager ~fY1,~ -'~~1/4~ BusPhone: (661} 324-2491 Location: 1921 18TH ST Map 102 CommHaz Minimal City BAKERSFIELD Grid: 25D FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb SIC Coder8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title JAMES B GRIMES MD / ~~f!'~~ C ~U'P.U~,~IQ/i^ ~ / Business Phone: (661) 324-2491x ~ Business Phone: ( ) ~ - x 24-Hour Phone (8.00) 821-0053x 24-Hour Phone -( ) - x Pager Phone ~_:-'(- ~~.) =-= __ -_ __ _ x -Pager Phone ( ) - x Hazmat Hazards: - - React Contact JAMES B GRIMES MD - Phone: (661) 324-2491x MailAddr: 1921 18TH ST ~- State: CA City BAKERSFIELD Zip- 93301 Owner JAMES B GRIMES MD .Phone: (661) 324-2491x Address 1921 18TH 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 ~ ~ Based on mt~ in~ulry cat abe~~~ i~~di,r,i~ds.«is far ~ak~ta2r~m~ tb~ i~s~~r-~?~tion, { certify l i e b respons under penalty cat law th€~t { haue personally examined and am familiar waith the information submitted and believe the i~f~pmation is true, accurate, and complete. -~ ~ e ~ E~~ AP Si ature Date ~~- R t~ U ~QO' -1- 02/01/2007 ~, F KERN.!'BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ ~ 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 30.00 GAL Min -2- 02/01/2007 -3- 02/01/2007 F KERN BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ ~ 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# Liquid TWaste ~Ambient~E ~ AmbientT~E ~LASTICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 GAL 30.00 GAL 30.00 GAL _.. -_._.. TTT PfTTTl~TTM /"1 /'~1dT l'.1~TT~TTA '- _.___ -. _ _ _._. -~ ru~,c,titcLUUa ~.ui~irulvr~ivl~ %Wt. RS CAS# Silver No 7440224 riAGHKL ASJlSSS1~1t;1V"1"a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/01/2007 l ~ F KERN BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification ~~ - -- _ - - employee Noti~./evacuation Public Notif./Evacuation emergency i~ieaical rlan V "~ -5- 02/01/200 -~ F KERN BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention _, -,-= - i~cicaac ~.Vti~.aiiiiucii~ C~~~~~V ~~~ e~Y,~s+'"1~~~ Clean Up ~~,`I~IT Vlr11C1 1CC5VLLI.LC HL L1Vdl.lVll (~ -6- 02/01/2007 l' 's. `~,. ~ ~ F KERN~,~BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ Fast Format ~ ,Site Emergency ,Factors Overall Site ~ ~„ , i ~' Q, ~i~C T I I~ (,fit ~~ `'~ D U11lil lly Vl.: I.: U~JQlll.:y LCVC1 ~. -7- 02/01/2007 ~ .~% 3; • ~~• F KERN~BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ ~~ Fast Format ~ ,Training Overall Site ~ r ~-. Employee Training ~4~u~~~, S a~~ ~~~ ~ rayc c. nc.LU iv.c r u~u.L~ use ncl.u ivi rul.ul.C u5C -$- 02/01/2007 ~..:-. KERN .BONE & JOINT SPECIALISTS Manager RINA FAUN Location:. 1921 18TH ST City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: SiteID: 015-021-002307 BusPhone: (661) 324-2491 Map 102 CommHaz Minimal Grid:.25D FacUnits: 1 AOV: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title JAMES B GRIMES MD / OWNER BRIAN C BRENNER MD / OWNER Business Phone: (661) 324-2491x Business Phone: (661) 324-2491x 24-Hour Phone (800) 821-0053x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact JAMES B GRIMES Phone: (661) 324-2491x MailAddr: 1921 18TH ST State: CA City BAKERSFIELD Zip 93301 Owner JAMES B GRIMES MD Phone: (661) 324-2491x Address 1921 18TH 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 ~'t.?hr_: on my ir~ruiz~r tit these inciivi~kuals rest-<~n:ii:~i 'i;~r Rk~t:a;,ri~r~ tha int:?rrnatiorr, I r..~~rtity un~:~F,r ~~e~,zit~r r~ kaw that 'r have per:~onali~,r ~s~aminr~c; r: ~r am familiar with the irttarmatinn su*4~~+r+kitad and k~clieve the infiormatirSn is true, accur:^+te, and complete. ~C/~°~ ~ j l.? IO ~ ~ __ . Siyna ire 'Oats -1- 07/12/2007 ;: F KERN BONE & JOINT SPECIALISTS ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-002307 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 30.00 GAL Min -2- 07/12/2007 -3- 07/12/.2007 F KERN BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ /'1/\1~A11 R/"1TT TTT 11RT1 I IYT TT1~1fT /YTT ITT 1RT ' AMOUNTS AT THIS LOCATION - Largest Container Daily Maximum I Daily Average 30.00 GAL 30,.00 GAL 30.00 GAL - t1AGHtCLVU~ lrV1~lYV1VL'1V1a %Wt. RS CAS# Silver No 7440224 nric~nrcL r-~a ar,aaril~,1y1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/12/2007 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste -~mbient ~ Ambient PLASTIC CONTAINER F KERN BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ by C11U ~/ 1VU1.11.1 Cd1-1011 i_ P~Ul~J1VyCC 1VUl.1L . / P~VdC:Udl.1U11 ~~~~.."~'t~ ~~ G4.t~~. Vic. ~s.~t~ -- ~T~'~'t;x,+aa ~2 ~~~-+E? tom" ~,.. _:..~ ~ . a per. ~ e. ~~ ~ ~, 1. f ~ ~. ~ ~;x. ~"c ~F-. ~~,, ,, ~ Fr~-v _7 _L 1 _ ! L /T - tUJ/llV 1VV 111 . ~ 1JVCL \.LLQ. l.1 Vll Emergency Medical Plan VERNON SORENSEN MD OR MERCY HOSPITAL 04/06/2007 -5- 07/12/2007 F KERN BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/06/2007 ~ SECONDARY CONTAINMENT Release Containment 04/06/2007 C~ ~TF~,-I~®I~~'r-I~d~ Clean Up SPILL KIT 04/06/2007 Other Resource Activation -6- 07/12/2007 F KERN BONE & JOINT SPECIALISTS SitelD: 015-021-002307 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ a,Ncc.la..L ncaGCil.u~ Utility Shut-Offs 04/06/2007 GAS: BACK OF OFFICE IN ALLEY ELECTRICAL: ELECTRICAL RM WATER: BACK OF OFFICE IN ALLEY ~ Fire Protec./Avail. Water 04/06/2007 FIRE EXTINGUISHERS Building Occupancy Level 04/06/2007 72 -7- 07/12/2007 ,. F KERN BONE & JOINT SPECIALISTS SiteID: 015-021-002307 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 04/06/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: ANNUAL SAFETY MEETING Page 2 nC 1C.1 LVL t'Ut~LLLC V.7~C 17G 111 1VL 1'UI.ULC U.y.-C -8- 07/12/2007 I ~ ~ ~jG ~ ~~ ~~ = - - ~ ` _ Prevention Services UN-II`~I~.P.ROGRAM INSPECTION CHECKLfST A A ,- F R s F, p 9ooTruxtunAve., suite2io - ~--- ~ ;~ FARE Bakersfield, CA 93301 D ~ aRrM Tel.: (661) 326-3979 - SECTLON 1: Business Plan and.lnventory Program Fax: (661) 872-2171 FACILITY NAME ~ INSPECT ON DA E ~ ° -J INSPECTION TIME - ~ ^~ 3oN,f ~ J a ~ ,~;-r S ~G c 1 R1-.t s i 5 ~ l a ~ ADDRESS (- ~ - - / . ~ , ~ a ~~ ~ PHONE NO. n', p ~ 2T '~ GTf /~ NO OF EJ~IRp~LOYEES ~ 4/ FACILITY CONTACT - BUSINESS ID NUMBER 15-021-BIS- OZ1 -(~ Section 9: 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 ^ BUSIIIeSS 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 ~ ~ -~.Q ^ CONTAINERS PROPERLY LABELED 2 Q ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ~i ANY HAZARDOUS WASTE ON SITE? '-~i ES ^ NO EXPLAIN: `'~~ `t '~- ~ X EVZ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 C~ ~ +t'i1L .~~~ Inspector (Please Print) Fire Prevention / 1s' In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy - ~ ~ FD 2155 (Rev. 09/OS r b. `~ _n` CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES iJNIFIEID PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakers>Iield, CA 93301 FACILITY NAME 1c E a_ti 13°~,~ ~ `~a ~ ~'-t" INSPECTION DATE ~ ~ ~ ~ ~ ri Section 4: Hazardous Waste Generator Program EPA ID # ~'~` ~ '"' ^ Routine ~ Combined ^ Joint Agency ^Multf-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 aze kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line J~' Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste /'~ Proper management of lead acid batteries including labels ~J Proper management of used oil filters 1 Transports hazazdous waste with completed manifest Sends manifest copies to DTSC ,' t J ~ a-, Retains manifests for 3 years moo, ~ Retains hazazdous waste analysis for 3 years Retains copies of used oil receipts for 3 years ~ ~ Determines if waste is restricted from land disposal ~=~ompuancre v=vioianon ~ _ Inspector: (' ~"~~"`~~-- Office of Environmental Services (661) 326-3979 B ~ ss esponsible Party White -Env. Svcs. Pink -Business Copy