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Home My WebLink AboutBUSINESS PLAN 7/9/2007ARMSTRONG DDS THOMAS F SiteID: 015-021-002322 Manager :_CYNTHIA OHMAN Location: 2100 18TH ST City BAKERSFIELD BusPhone: (661) 631-5580 Map 102 CommHaz Minimal Grid: 25D FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title THOMAS F ARMSTRONG / OWNER KAREN ARMSTRONG / OWNERS WIFE Business Phone: (661) 631-5580x Business Phone: (661) 631-5580x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React • Contac t ~: - THOMAS-- F ARMS TRONG - -- - - - - - Phone: ( 6 61) 6 31- 5 5 8 0 x MailAddr: 2100 18TH ST State: CA City BAKERSFIELD Zip 93301 Owner THOMAS F ARMS TRONG DDS Phone: (661) 631-5580x Address 2100 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 EN ~ ~tl ~~~ 1 1 zoo, - - - - - - E3a,ed on my_inquiry of those indiiidetrfy the infiormatio~~ rsonally responsible for obtaining IaU~ that 1 have p under penalty ofi ormationo is true, e i ie e'Ithew n n exam ~ and bel itte subm le. accurat and c -7 Q pate Signature -1- 06/29/2007 t + ARMSTRONG DDS THOMAS F ______________________________ SiteID: 015-021-002322 + Manager.: Location: 2100 18TH ST City BAKERSFIELD BusPhone: (661) 631-5580 Map 102 CommHaz Minimal Grid:-25D FacUnits: 1 AOV: CommCode: BFD STA O1 SIC Code:8011 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title THOMAS F ARMSTRONG / DDS PAM BROWN / Business Phone: (661) 631-5580x Business Phone: (661) 631-5580x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x ~~ Hazinat -Hazards " ~- - - .. __ _ . __ . _ _. _ _ -- React Contact PAM BROWN Phone: (661) 631-5580x MailAddr: 2100 18TH ST State: CA City BAKERSFIELD Zip 93301 Owner THOMAS F ARMSTRONG DDS Phone: (661) 631-5580x Address 2100 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 ~~~ ///,, SJ~/ ® 8 ~oob+ 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, accurate and co ~i' Signature Date G -1- 05/10/2006 S; ... : 4 ARMSTRONG DDS THOMAS F ~(rot~ SiteID: 015-021-002322 ;Manager "~~(,7w1 ~~i r l~~U~~712~~ /~'J~ Location: 2100 18TH ST City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: BusPhone: (661) 631-5580 Map 102 CommHaz Minimal Grid: 25D FacUnits: 1 AOV: SIC Code:8011 DunnBrad: Emergency Contact / THOMAS F ARMSTRONG / Title ~ DDS ~~i~~~-;` Emergency Contact / ;Title - C7/L~'~& V~~ANC9N(~C~ j~J}I~~=~?~ Business Phone: (661) 631-5580x Business Phone: (661) 631-5580x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact : , ~fG'1M~5 ~~w-~Ti~ilL~~- /~/J S Phone : ( 6 61) 6 31- 5 5 8 0x MailAddr: 2100 18TH ST State: CA City BAKERSFIELD Zip 93301 Owner THOMAS F ARMSTRONG DDS Phone: (661) 631-5580x Address 2100 18TH ST State: CA City BAKERSFIELD Zip 93301 Period to Preparers Certif'd: ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~~~~ f3a~ed on my inquiry of those individuals respanaible 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, accurate, and comple e. -3 a~ Signature Date TotalASTs: = Gall TotalUSTs: = Gal' RSs: No I~Mp 4 -1- 03/20/2007 -, F ARMSTRONG DDS THOMAS F SiteID: 015-021-002322 ~ ~ 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 2.00 GAL Min -2- 03/20/2007 -3- 03/20/2007 F ARMSTRONG DDS THOMAS F SiteID: 015-021-002322 ~ ~ 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 ~ AmbRent~E ~ AmbientT~E -~STOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container. Daily Maximum Daily Average 2..00 GAL 2.00 GAL 2.00 GAL HAZARDOUS COMPONENTS °sWt . RS CAS# Silver No 7440224 I1L-1GKKL H. 7 ~7.C,.7.71~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 03/20/2007 c F ARMSTRONG DDS THOMAS F SiteID: 015-021-002322 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ Hy C11C:y 1VV 1.111C:dL1U11 ~~ r /~ L'llli/1 VY GG 1VV 1.11 . ~ ~V0.l. UCL l.1 Vll i ~-. r UiJ11V 1VV V11 ~ 1S VCL l.UdL1V11 -5- 03/20/2007 -, F ARMSTRONG DDS THOMAS F SiteID: 015-021-002322 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention Release Containment ,., C LL fl-N ~-~7' 1aC ~7~ E _ _ C~ ,~7'l~j `i7AfLL~/-.~ PNG~jL~GGrL,~PIfIC ~'t'RCt? ~ }i7LLr:~G(> ~~,~ U sT:~~ ~mn;:a~',~ s v~.iica. ncAVU1\.c til:l.l V 0.1.1V11 -6- 03/20/2007 ~ ,~ ~ F ARMSTRONG DDS THOMAS F SitelD: 015-021-002322 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~YCt:.~al ncl~aiu5 ',Utility Shut-Offs - ~C-l~cu~i` (~1~+1~~ IuS~/~ ~jk~a~~N(~ /~ tn~~-~~ ~fAcciv~Y Fire Protec./Avail. Water J Ci~+tS~iJG' ~1/f+T~ 5~/Gcn'S ~"/v 0,957' ~3iv~ ~°G~i=7N Lt/41LS, ~l(0.~ 1-I~A~Aivr ~N /Vo~r~;T S~~SE dam' ~icuL~eN(s ~,~-IC~,~U(ry ~cr` ,' Ar AtLC-z; ~N7VZANct vN fJ ~ 5?~7'. . D 11111.L111y VC:L U~Jd11C: ~/ LCVC1 1Maxiw.~,M, L=w~~`t~~'~s Pr.v~1 cLl~~t=S~,~`~~r~C~rS ~s["-r"V!'~'.~ ~~+~ ~~ . ~~~vs -7- 03/20/2007 :; ., , F ARMSTRONG DDS THOMAS F SiteID: 015-021-002322 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training; ~c P4^ i ic.rl~A~J rv S~F~-r`f TJrA,a~,~:~- ~G'-cC:,,~p~,~ SAO~~sc,~~ 13`~ ~~~.' Cac.,,,t` /~~rhL 5cc~~r; , rayc c nciu Lvi r u~.uic Vac nciu tvt rUI.uLC VaC -8- 03/20/2007 ~lOl - - '' ~ Prevention Services UNIFIE°~ROGRAM INSPECTION CHECKLIST '', A F :~r R S F , . ,, 90o Truxtun Ave., suite 2l0 _. I FIRE. Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program d,f~ARfM ' T Tel.: (661) 326-3979 t~~' Fax: (661) 872-2171 FACILITY NAME INSPECTION D TE INSPECTION TIME J/~~ 1~~-^~S"r Q- O N ~ S ~ S~~j ADDRESS O f ~ ~ ~ ON ~ NO~~G NO OF~ LOYEES FACILITY CONTACT ~ BUSINESS ID NUMBER 15-021- b/S -o Z1-~ Section 1: Business Plan and Inventory Program j ^ ROUTINE 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 ~B ^ EMERGENCY PROCEDURES ADEQUATE ~ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HANG ANY HAZARDOUS,~(vASTE ON SITE? YES ^ NO W q Smote.. .~~ X E jL EXPLAIN: ~~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Gr~~-/- Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # White -Prevention Services - Yellow -Station Copy Pink -Business Copy nsible FD 2155 (Rev. 09105 . js'" ~~°~~`- ~'rte`~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~d ~~ OFFICE OF ENVIRONMENTAL SERVICES ~' y UNIFIED PROGRAM INSPECTION CHECKLIST Gk•F'' Agtip~~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME I~~-d`^S'(~ N G ~ 17S INSPECTION DATE ~ `~ C~ Section 4: Hazardous Waste Generator Program EPA ID # ~ ?~ £ ~- P~ ^ Routine ~ Combined ^ Joint Agency ^Mufti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~ y ~, ,., p ~-` 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 N ~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC ~. r ~ ~ 0 4 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 ~=~ompttance v=vtotanon Inspector: C, ~~~~` .~-. ' Office of Environmental Services (661) 326-3979 usiness Site onsible Part White -Env. Svcs. Pink -Business Copy