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HomeMy WebLinkAboutBUSINESS PLANN D N s ~ ~ i ~ Q 'O ~ M M D ' J l _ _ __ :~`• . `.:.~. YEOMAN DDS LELAND R SiteID: 015-021-002302 Manager CRIS JACOBS Location: 3301 19TH ST A City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: BusPhone: (661) 325-1263 ,Map 102 CommHaz Minimal Grid: 26B FacUnits: 1 AOV: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title LELAND R YEOMAN DDS / OWNER DANA L YE OMAN DDS / OWNER Business Phone: (661) 325-1263x Business Phone: (661) 325-1263x 24-Hour Phone (661) 706-6100x 24-Hour Phone :. (661) 340-4178x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact ~jPcnUq -L. yEDM~I - Phone: (661) 325-1263x MailAddr: 3301 19TH ST A State: CA City BAKERSFIELD Zip 93301 Owner LELAND R & DANA L YEOMAN DDS Phone: (661) 325-1263x Address 3301 19TH ST A State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers Tot alUSTs: = Gal. Certif' d: RSs : No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~NT~ ,~ ~ ~, ~ Q ~~~~ 0• ^~d on my inquiry of those indiv!;;u~~; r~4~pcnrib!e for obtaining the inform ti a on, I criify undor penalty of law that I have personally examined anti am familiar with the inf b Ju orma_fion mitted and believe the information i acc t s rue, ,rate, and complete . ~~ 7 Signatur a~~ d 7 e -1- 07/16/2007 .i F YEOMAN DDS LELAND R ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-002302 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... ISpecHazIEPA Hazards) Frm I DailyMax IUnitIMCPI WASTE FIXER R L 5.00 GAL Minl -2- 07/16/2007 [' 9 f C' -3- 07/16/2007 ~_ F YEOMAN DDS LELAND R SiteID: 015-021-002302 ~ ~ 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: OUTSIDE LAB CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWasteAmbient ~ Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL - -- tY[iGLi.tCLVUJ trV1~1rV1vtSlvla %Wt. RS CAS# 'Silver ~~ -~ No 7440224 riAGAltL A~~l'~551~1L~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/16/2007 ~. , i F YEOMAN DDS LELAND R SitelD: 015-021-002302 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 05/23/2006 ~ 911 AND CALIFORNIA DEPARTMENT OF TOXIC SUBSTANCES CONTROL. Employee Notif./Evacuation 05/23/2006 VERBAL AND INTERCOM SYSTEM. -- Public Notif./Evacuation 05/23/2006 VERBAL AND INTERCOM SYSTEM. Emergency Medical Plan 911 09/13/2005 -5- 07/16/2007 ~s F YEOMAN DDS LELAND R SiteID: 015-021-002302 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/06/2004 ~ CONTAINED BY SECONDARY PLASTIC CONTAINERS. Release Containment 05/06/2004 PLASTIC - "CONTAINERS . - ` - - - ~ - - - - - - - - - - . _ Clean Up 05/23/2006 CONTAIN SPILL AND FLUSH TO SEWER WITH LARGE AMOUNTS OF WATER. WEAR PROTECTIVE CLOTHING AND GLOVES. v~.iict itc.7VULl.:C 1i1: 1.1Vd1,1U11 -6- 07/16/2007 F YEOMAN DDS LELAND R SiteID: 015-021-002302 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _, ,_ .~Nc~.iai naaaiua = Utility Shut-Offs 07/14/2006 = GAS - - -NE - CRNR OF BLDG- - -- - - --- ---- _ _ __._ _. _ _ -- - _-- . -~ _- - - - - - -- --- - Fire Protec./Avail. Water 07/14/2006 FIRE EXTINGUISHERS USED FOR PRIVATE FIRE PROTECTION. NEAREST FIRE HYDRANT - 19TH ST NW CRNR OF BLDG. Building Occupancy Level 05/23/2006 6 EMPLOYEES -7- 07/16/2007 .~ . ; r.,. N F YEOMAN DDS LELAND R SiteID: 015-021-002302 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training 05/23/2006 BRIEF SUMMARY OF TRAINING PROGRAM: WE HAVE OSHA TRAINING. rayc c. nciu ivi ru~uic uCC naiu ivi r u~uiC 1.150 -8- 07/16/2007 _ . _ ~~,- ~~ ~~~~~ UNIFIED PROGRAM lNSPEGTION.CHECKLIST ~y"~~`-~ Prevention Services e A : e R s .F , „ 900 Tntxtun Ave., Suite 210 - ~ FIRE :, Bakersfield, CA 93301 _ v aRr.M Tel.: (661) 326-3979 SECTION 1: Business Plan and Inventory Program -- Fax: (661.) s72-2171 .FACILITY NAME C--o~iaN l)~S INSPECTI N DAT )°f INSPECTION TIME ADDRESS ~~~ / ~ ^ iL ~~ PHONE O~l 263 O OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 15-02 1-b/S~oZ-)'O© ^ _ Section 1: 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 ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~N~~ , ~tl ^ VERIFICATION OF QUANTITIES . 07 ~0 ^ VERIFICATION OF LOCATION \ '6 ~ ^ PROPER SEGREGATION OF MATERIAL \ - ~1 ^ VERIFICATION OF MSDS AVAILABILITY ~Il ^ 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 HAZAFR;~DOUS (lW~ASTE ON SITE? AYES ^ NO EXPLAIN: `"' O S T"~ '` 1 X~~ ?-3~-L QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~ ~~~ ~., 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 .'-` - r r"• ~` T~'`~ CITY OF BAKERSFIELD FIRE (DEPARTMENT ~~pp OFFICE OF ENVIRONIVIENTAL SERVICES •yAP UNIFIED PROGRAIVI INSPECTION CHECKLIST ~kg`~t~ti,VN 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME Y~ o ~"~~ N D e s INSPECTION DATE J 9 ~~ Sect6on 4: Hazardous Waste Generator Program EPA ID # ~~ti ~•^- ~'~ ^ Routine -!~ Combined ^ Joint Agency ^Muhi-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~~ ~--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 N Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste ~ ~ Proper management of lead acid batteries including labels /U Proper management of used oil filters ~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC ~(~ g~/~ r ~~ ~ ~ J 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 ~s c;=c;ompuance v=violation Inspector: G ~G~JL ~_ Office of Environmental Services (661) 326-3979 White -Env. Svcs. t P usiness S t Responsible Party Pink -Business Copy r. _~,.. :i 71 + YEOMAN DDS LELAND R _________________________________ SiteID: 015-021-002302,+ Manager Location: 3301 19TH ST A City BAKERSFIELD BusPhone: (661) 325-1263 Map 102 CommHaz Minimal Grid: 26B FacUnits: 1.AOV: CommCode: BFD STA O1 SIC Code:8021 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title LELAND R YEOMAN DDS / DANA L YEOMAN DDS / Business Phone: (661) 325-1263x Business Phone: (661) 325-1263x 24-Hour Phone (661) 706-6100x 24-Hour Phone (661) 340-4178x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact LELAND R YEOMAN DDS Phone: (661) 325-1263x MailAddr: 3301 19TH ST A State: CA City BAKERSFIELD Zip 93301 Owner LELAND R YEOMAN DDS ~a,llpi ~,„Ye,~rYt.Q~~l~S. Phone: (661) 325-1263x - Address ~: -3301 19TH ST A ~ 3301 (a~ S1" ~ State: CA City BAKERSFIELD ~Ot~S'FtG~l~l Zip 93301 ---------------------------------------------- Period to TotalASTs: - Gal Preparers TotalUSTs: - Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~p~ PROG H - HAZ WASTE GEN ~v l d~ ~ EN ~/ ~aaecf on my inquiry of those individuals reaponalk)fe for obtalnin~ tha information, I certify unc#pr f~enalty of law that I have personally examl~iaS~ end am famlll~r with the information s,.,hrryjtted er~d believe the information is true, aecurafe, anc~ complete. vu~ 14 2p06 ~~~ ~ 55~ -1- 05/23/2006 z. i^ } i' YEOMAN DDS LELAND R Manager ~~.~s_. J~tCC~M3S Location: 3301 19TH ST A City BAKERSFIELD SiteID: 015-021-002302 BusPhone: (661) 325-1263 Map 102 CommHaz Minimal Grid: 26B FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title____ LELAND R YEOMAN DDS / OWNER DANA L YEOMAN DDS /. Q,D,S, ' Business Phone: (661) 325-1263x Business Phone: (661) 325-1263x 24-Hour Phone (661) 706-6100x 24-Hour Phone :. (661) 340-4178x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact LELAND R YEOMAN DDS Phone: (661) 325-1263x MailAddr: .3301 19TH ST A ~ State: CA City BAKERSFIELD Zip 93301 Owner LELAND R & DANA L YEOMAN DDS Phone: (661) 325-1263x Address 3301 19TH ST A 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 r ,>c ~ ,? t~r~ try !r'as~~;ry of ttsese iridividuais snin~ the information, I certi y ll b> `~ ~/~ i ii ® ~`~ ~ ~ N y _r,,; ~;'nl;: ft}r e ra.::,~:. `~.:~ cf iav~ that I have persona , ~~~ ~ true e ii f , is the nfo mation eve n b ii , rn itt d a ~ r at; , :u~ate, 3~id complete. ar . ~ (a'L ~ --------°~-_` p Signaturti -1- 02/20/2007 ~~ F YEOMAN DDS LELAND R ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-002302 ~ By Facility Unit ~ Fixed Containers at Site ~ _- Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 5.00 GAL Minl -2- 02/20/2007 -3- 02/20/2007 c F YEOMAN DDS LELAND R SiteID: 015-021-002302 ~ ~ 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: OUTSIDE LAB CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWasteAmbient ~ Ambient ~LASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL -- - r~r-~~r~rcl~vu~ wlnrulV~1V1~ %Wt. RS CAS# Silver No 7440224 riAL,AKlJ Aa51~;5~1~11~;1V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/20/2007 ,. F YEOMAN DDS LELAND R SiteID: 015-021-002302 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 05/23/2006 ~ 911 AND CALIFORNIA DEPARTMENT OF TOXIC SUBSTANCES CONTROL. Employee Notif./Evacuation 05/23/2006 VERBAL AND INTERCOM SYSTEM. Public Notif./Evacuation VERBAL AND INTERCOM SYSTEM. 05/23/2006 Emergency Medical Plan 09/13/2005 911 -5- 02/20/2007 F YEOMAN DDS LELAND R SiteID: 015-021-002302 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/06/2004 ~ CONTAINED BY SECONDARY PLASTIC CONTAINERS. Release Containment 05/06/2004 PLASTIC CONTAINERS. Clean Up 05/23/2006 CONTAIN SPILL AND FLUSH TO SEWER WITH LARGE AMOUNTS OF WATER. WEAR PROTECTIVE CLOTHING AND GLOVES. Other Resource Activation -6- 02/20/2007 1" ,. F YEOMAN DDS LELAND R SiteID: 015-021-002302 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ JLJCC:1d1 !ldGdIUS Utility Shut-Offs 07/14/2006 GAS - NE CRNR OF BLDG Fire Protec./Avail. Water FIRE EXTINGUISHERS USED FOR PRIVATE FIRE PROTECTION. NEAREST FIRE HYDRANT - 19TH ST NW CRNR OF BLDG. 07/14/2006 Building Occupancy Level 6 EMPLOYEES 05/23/2006 -7- 02/20/2007 +- . F YEOMAN DDS LELAND R SiteID: 015-021-002302 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/23/2006 ~ BRIEF SUMMARY OF TRAINING PROGRAM: WE HAVE OSHA TRAINING. rctyc a aaciu ivi i•u~.uic v.~c nciu ivi ru~uic vac -8- 02/20/2007