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BUSINESS PLAN 4/19/2007
i ~ ~._-~__ s _---~ = - --=- -- - ~~o~`~ "~`~' Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST R ., F R s ~ , D 90o Truxtun Ave.; suite 210 FARE Bakersfield, CA 93301 SECTION- 1: Business Plan and Inventory Program ,"RT"' Tel.: (661) 326-3979 ;::~ Fax: (661) 872-2L71 FACI{ITY NAME ~ ~ INSPECTIQN DATA / ~ { INSPECTION TIME - A~ 6 s ~ / l / G~j ADDRESS ~(~ - ~ ~ 2 22' PHONE NO. - ~Zj ~ 3~0 NO OF EMPLOYEES 7 FACILITY CONTACT BUSINESS ID NUMBER 15-021-©j S-~Z) -O Section 1: Business Plan and Inventory Program - _ ___ _-- - _ _ _ _ ^ < ROUTINE ~$ COMBINED ^ JOINT AGENCY ^ MULT!-AGENCY ^ COMPLAINT ^ RE-INSPECTION 1 C V ~ C=Compliance` OPERATION V=Violation l COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIt1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~ t~ ~ ~ ~ ~j (J ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING / '~ /--~c1^~ 5 ~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZA~R!D~OUS WASTE ON SITE? EXPLAIN: WC' S~~ ~~~C°r ~1 v/ /1 c. ~'ES p ^NqO Q.~dJVCI JC7 v~QS~'a., ~aGl~l~ >z~~~~ ~-t.~ an. a j 1 QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # Business Si e / Responsib a arty (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy - FD 2155 (Rev. 09/05 ~A~ i ~~~~~ -^~° CITY OF BAKERSFIELD FIRE DEPARTMENT ~d b OFFICE OF ENVIRONMENTAL SERVICES ~,, UNIFIED PROGRAM INSPECTION CHECKLIST °_'t~` ~ gti~ ~ 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 4~4I~ FACILITY NAME ~ AGI-n~ ~s ~~ ~^'` INSPECTION DATE `~/~ ~ ~~ Section 4: Hazardous i~Vaste Generator Program ^ Routine ~ Combined ^ Joint Agency 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 IS days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers aze 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 ~ ~, Secondary containment provided ~v p _.~}af'+S~ Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste /~ J1~ Proper management of lead acid batteries including labels N ~ Proper management of used oil filters /V ~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC ~ ~ ~ ~ c~ Retains manifests for 3 years a-«~ w s~~-'~' a''~ ('j L.~~}'4 ~ Retains hazazdous waste analysis for 3 years °1 Sc , v+ Gc_. Retains copies of used oil receipts for 3 years J~ Determines if waste is restricted from land disposal ~=~ompnance v=vroranon Inspector: ~ ~~k ~ `~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. EPA ID # ^ Multi-Agency ^ Complaint ^ Re-inspection Pink -Business Copy ~r ~. ,. Business Site Responsible Party `I```I ~~~ I ~+ BARNES DPM BRENDA & SAMUEL __________________________ SiteID: 015-021-002321 + Manager BusPhone: (661) 327-3205 Location: 2227 19TH ST ~ Map 102 CommHaz Minimal City BAKERSFIELD Grid: 25B FacUnits: 1 AOV: CommCode: BFD STA Ol SIC Code:8011 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title BRENDA BARNES / DPM SAMUEL BARNES / DPM Business Phone: (661) 327-3205x Business Phone: ,(661) 327-3205x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager. Phone ( `(Q(Q~) ')d (o 3 z~ ~c Pager Phone ( ) - x Hazmat Hazards: ~ _ ___ _-_ _ _ React _ Contact BRENDA K BARNES DPM Phone: (661) 327-3205x MailAddr: 2227 19TH ST State: CA City BAKERSFIELD Zip 93301 Owner BRENDA K BARNES DPM Phone: (661) 327-3205x Address 2227 19TH 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 ~~~L~ ~Nfi ",~ ~ ~~ ~ ~ ~~~~ Based on my inquiry of those individuad~ responsible far 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 complete. e Date. ~~°~ V~ -1- 05/10/2006 IFy- '~y.'f `~ES DPM BRENDA & SAMUEL Manager : ,~~r,~~~~~~, ~ .' ~-~~c: s n-f' S Location: 2227 19TH ST City BAKERSFIELD CommCode: BFD STA O1 EPA Numb: SiteID: 015-021-00231 BusPhone: (661) 327-3205 Map 102 CommHaz Minimal Grid: 25B FacUnits: 1 AOV: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title BRENDA BARNES DPM / (c~ ~~;~,,~.-~~ ~ SAMUEL BARNES DPM / (. ~~ -~!~-J r' ~ ~ Business Phone: (661) 327-3205x Business Phone: (661) 327-3205x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661) 706-3205x Pager Phone ( ) - x Hazmat Hazards: React Contact BRENDA K BARNES DPM Phone: (661) 327-3205x MailAddr: 2227 19TH ST State: CA City BAKERSFIELD Zip 93301 Owner BRENDA K BARNES DPM Phone: (661) 327-3205x Address 2227 19TH 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 ~'N kias~d nn rn~' I11r' II i 1 r~~ ~r j. II'} (.> tl~rtcra in!11ViCllI;~IS t. )n'sj!;Ir? t, t!, rjl~!~jnillij !!7^ j1if~~trri;tliOrl ,r I ~p - //~~ /`~ I ~l'K ~ M c~ /V% ~~~~ {;c - tity under pen~~lty n! latrll~~:~r! I h • , a ~ ~ ,nrsortally ex~minerl and ern larni!iar ~~;;!~, the ir~f<~rmation SUt7rT111ted and r!r!in l r r, l t1r: Itl!nrtlUltlClll I<: trl.le, aCCUr~rtp, and Corrl!-IIr?t~-~ I ?ate -1- Ol/26/~b07 j~~4~.5~"~. ~ f~~:.. 'r~~IES DPM BRENDA & SAMUEL SiteID: 015-021-002321 ~ ~~~~ Fast Format ~ r''Notif./Evacuation/Medical Overall Sits ~ ~- Agency Notification 05/10/2006 ~' ONE EMPLOYEE TO CONTACT PG&E OR FIRE DEPARTMENT, AS APPROPRIATE. IF GAS LEAK, EMPLOYEE AND OWNERS CAN TURN GAS OFF. Employee Notif./Evacuation 05/10/2006 ONE EMPLOYEE TO CONTACT PG&E OR FIRE DEPARTMENT, AS APPROPRIATE. IF GAS LEAK, EMPLOYEE AND OWNERS CAN TURN GAS OFF. = Public Notif./Evacuation d~ ~: ~ ~~ , e Emergency Medical Plan 10/10/2006 UATE BUILDING IF NECESSARY. WE HAVE FIRST AID SUPPLIES. CALL 911 IF SSARY. MERCY HOSPITAL IS THE CLOSEST HOSPITAL. -5- 0l/26/zuo~ =~~ TES DPM BRENDA & SAMUEL SiteID: 015-021-002321.E ~- Fast Formdt ~ :Site Emergency Factors Overall Sits ~ Special Hazards Utility Shut-Offs ~-C. ~ //~~ ,_ L'1tC t'1.Vl.Ct.:. /HVd11 Wdl,Ct ~ 1 ~~ DU11 u111y v~~uYdiiuy LCVC1 -~- oi/26/200~ ~....r.r.,.~j BARNES DPM BRENDA & SAMUEL Manager BRENDA K BARNES Location: 2227 19TH ST City BAKERSFIELD SiteID: 015-021-002321 BusPhone: (661) 327-3205 Map 102 CommHaz Minimal Grid: 25B FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title BRENDA BARNES DPM / CO- OWNER SAMUEL BARNES DPM / CO-OWNER Business Phone: (661) 32 7-3205x Business Phone: (661) 327-3205x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661) 70 6-3205x Pager Phone ( ) - x Hazmat Hazards: ~ React °"'Cont~ac t' : BRENDA K~ BARNES Phone : ( 6 61) 3 2 7- 3 2 0 5 x MailAddr: 2227 19TH ST State: CA City BAKERSFIELD Zip 93301 Owner BRENDA K BARNES DPM Phone: (661) 327-3205x Address 2227 19TH 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 ~N~~ ~! ~ `~ ~ ~~~~ i~a bd oh rrty Inquiry of thaw ind(viduais r€~~~i~nr:lblo for obtaining the information, 1 rertify un~~ur ~enelty of law that I have personally examined and am familiar with the lnfarmation submitted and believe the information is true, accurate, and co late. ~~~-~~~~ .~~ a _a 7 Signature Date ~~ C Y1G~ , - n ~ -1- 06/29/2007