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Home My WebLink AboutBUSINESS PLAN 10/9/2007.~ ,I /~ ~~ ~~ ' '°~ `°~ Q:~~IID~I~Tt~I.e ~~~,~.,,..~,.e. C113 r.::-: ~~ ~~ \ F .- _ _ ~~ Manager MARY SUE FRANKLIN BusPhone: Location: 730 34TH ST Map 103 City BAKERSFIELD Grid: 19D CommCode: BFD STA 04 EPA Numb: ~q~~~ SiteID: ~a~ Ol -021-000340 a (661) 327-7687 CommHaz Low FacUnits: 1 AOV: SIC Code:8051 DunnBrad:93-102-6009 Emergency Co nt~ ~ / Title e,~e~~+;~~ Emergency Contact / Title • ~ ~ ~¢.c~a k\.~ / ~0`rutcf JORGE CHIPRES / MAINTENANCE Business Phone: (661) 327-7687x Business Phone: (661) 327-7687x 24-Hour Phone (t`o~,i) 3by- S9y~x 24-Hour Phone (661) 329-5251x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact MARY SUE FRANKLIN Phone: (661) 327-7687x MailAddr: 730 34TH ST State: CA .City KERS IELD Zip 93301 Owner Phone: (661) 327-7687x Address 730 34TH ST ~ as ;Q State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT f ~T,D ®~"'~' ~ ~ 007 Based on my inquiry of those individuals responsible for obtaining the inform ti a on, I rertify under penaity of la~v that I have personall y examined and am fanii!iar with the information submitted and believe the information is true , accurate, and complete. ~ 1 - Date -1- 07/13/2007 F PLEASANT CARE CONV HOSPITAL ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-000340 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN F P IH G 7500.00 FT3 Low -2- 07/13/2007 ~ '1 i -3- 07/13/2007 r F PLEASANT CARE CONV HOSPITAL ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit OXYGEN RMS (A WING & MEDICARE SECT) STATE TYPE PRESSURE _ Gas TPure -TAbove Ambient SiteID: 015-021-000340 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest C7500100rFT3 Daily7500100m FT3 I Daily7500r00e FT3 t11~GLittL V U .7 1, V1~lY V1V L' 1V 15 °sWt. RS CAS# 100.00 Oxygen, Compressed No 7782447 nt~~t~1cL rjaa~a~ln~ivl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low -4- 07/13/2007 '- F PLEASANT CARE CONV HOSPITAL SiteID: 015-021-000340 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 09/13/2000 ~ CALL 911. Employee Notif./Evacuation 09/13/2000 PAGING SYSTEM. Public Notif./Evacuation PAGING SYSTEM. 09/13/2000 Emergency Medical Plan TRANSPORT TO NEAREST HOSPITAL, ALSO, DOCTORS AND NURSES ON STAFF. 07/12/2006 -5- 07/13/2007 F PLEASANT CARE CONV HOSPITAL SiteID: 015-021-000340 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 07/12/2006 ~ OXYGEN CYLINDER CHAINED TO WALL. OXYGEN CANISTERS USED TO HOLD E (SMALL) OXYGEN TANKS. Release Containment 05/18/2006 REGULAR INSPECTION OF OXYGEN CYLINDERS; THAT THEY ARE CHAINED, SECURED, AND FREE OF LEAKS. ~..icau v~ V1.11C1 1CC w7VUll:C tll:LlVCi 1.1 Vll -6- 07/13/2007 ~; F PLEASANT CARE CONV HOSPITAL SitelD: 015-021-000340 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards 09/13/2000 ~ 120-140 SENIORS (MANY DISABLED). Utility Shut-Offs 06/18/2007 GAS - N ENTR ON W SIDE OF BLDG ELECTRICAL - S BULLPEN W SIDE OF BLDG WATER - NEXT TO GAS METER W SIDE OF BLDG LOCK BOX - YES Fire Protec./Avail. Water 02/21/2007 PRIVATE FIRE PROTECTION - FIRE SPRINKLERS, FIRE EXTINGUISHER, PULL BOX, AND SMOKE DETECTOR. FIRE HYDRANT - MOBIL STATION ON Q ST. Building Occupancy Level 03/01/2006 125 EMPLOYEES -7- 07/13/2007 ~tJ . ~~. - ~ ~, F PLEASANT CARE CONV HOSPITAL SiteID: 015-021-000340 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/18/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY ORIENTATION ON HIRE AND A YEARLY IN-SERVICE TO ALL STAFF ON SAFETY. rciyC G Held for Future Use Held for Future Use -8- 07/13/2007 " ~~ ~ Prevention Services UNIFIED PROGRAM .INSPECTION CHECKLIST - ~r B. f R s r, n 900 Truxtun Ave., Suite 210 ~~_..~w~. ..~~~~.. _..~A~~. ~.~ ~ ._~~~ ;~~~~~ __.~ ~~~~.~~~~ ~.. ~ F~R>F ~ ~ Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ° aRTM Tel.: -(661) 326-3979 - ~ Fax: (661) 872-2171 FACILITY NAME INSPE TION DATE INSPECTION TIME ADDRESS - _ _ - _'~, 3 0 ~-~- PHONE NO. 3Z7 - 76~ ~ NO OF EMPLOYEES_ , 3 y FACILITY CONTACT _~ BUSINESS ID NUMBER 15-021- dC~O,i ~ d Section 1: Business Plan and Inventory Program ^ ROUTINE Q 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 ~~~~~] _ !' J~ '±~ v ~+ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES Y ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^~ FIRE PROTECTION // y. 1.+?~r/ h 6kS >ti e r m T1 sd-~ N U'f` ~' ^ SITE DIAGRAM ADEQUATE & ON HAND r ANY HAZARDOUS WASTE ON SITE? ^ YES - LSaNO FXPI AIN• _- - - /~/ oT ~ ~~t -F , .~ ,q ~,, v s t, \ _~ .s~ s^~'e. ,~ e~-'C~~ /~ •~ c.1.`Q -\ ~ oo ~. ~ytt-~ ~u ID G'. C~ N iv a G'` L' ~ - ~.8 ~ I i/'e.-- % ~~ C a .~ ~ ~ ~~ `^ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~~~~~~ ~ ~ Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # Busi ss Site /Responsible Party (Please Print) White -Prevention Services ~ Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ]eanni Loven - ES Account & Bankruptcy From: Drew Sharpies To: Jeanni Loven Date: 5/9/2007 1:22 PM Subject: ES Account & Bankruptcy 3497-FI Pleasant Care Bakersfield BK Case #LA 07-12312-EC, Chapter 11 filed 3/22/07 Inactive the existing account, it has a zero balance. Open a new account and start the billing with the 07-08 fiscal year. The account should be set up as follows: Pleasant Care Conv Hospital 730 34th St Bakersfield Ca 93301 ~~ 3~~~ / ` ~~~~V 1 ~J ~ ~~~ ~~~ _ ,;. t> PLEASAN'T' CARE BAKERSFIELD SiteID: 015-021-000340 Manager ~a~ S„e~a.~K\~ -~ ;A~~;~:5-~~.+~~`. Location: 730 34TH ST City BAKERSFIELD BusPhone: (661) 327-7687 Map 103 CommHaz Low Grid: 19D FacUnits: 1 AOV: CommCode: BFD STA 04 EPA Numb: SIC Code:8051 DunnBrad:93-102-6009 Emergency Contact / Title Emergency Contact / Title LINA CRUZ J~s~}.ADMINISTRATOR JORGE CHIPRES / MAINTENANCE Business Phone: ('661) 327-7687x Business Phone: (661) 327-7687x 24-Hour Phone ( ) - x 24-Hour Phone (661) 329-5251x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact :~~ Svc ~~cs~~,K~;;J Phone: (661) 327-7687x MailAddr: 734TH ST ~ State: CA City BAKERSFIELD Zip 93301 Owner PLEASANT CARE BAKERSFIELD Phone: (661) 327-7687x Address 730 34TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers ~ TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT Based on my inquiry of those individuals responsible for obtaining the information, I certify ersonally t I have th l ~I~~t~ ~ ~ ® ~ A '~I ! a ~~~~ p a aw under penalty of . 1 examined and am familiar with the information submitted and believe the information is true, accurate, and complete. 2 S ~~~ Date Sig are -1- 02/06/2007 5 i F PLEASANT CARE BAKERSFIELD SiteID: 015-021-000340 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN F P IH G 7500.00 FT3 Low -2- 02/06/2007 rr .a -3- 02/06/2007 ii ~ ! . F PLEASANT CARE BAKERSFIELD SiteID: 015-021-000340 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: OXYGEN RMS (A WING & MEDICARE SECT) CAS# 7782-44-7 ~GasATE TYPE PRESSURE TEMPERATURE ~T~ CONTAINER TYPE ~ TPure Above Ambient Ambient I PORT. PRESS. CYLINDER I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 7500.00 FT3 7500.00 FT3 7500.00 FT3 HAZARDOUS COMPONENTS %Wt• RS CAS# 100.00 Oxygen, Compressed No 7782447 nriarucL ri ~aaaat~l~ly 1 a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low. -4- 02/06/2007 r F PLEASANT CARE BAKERSFIELD SiteID: 015-021-000340 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 09./13/2000 ~ CALL 911. Employee Notif./Evacuation 09/13/2000 PAGING SYSTEM. - _ __- Public Notif./Evacuation 09/13/2000 PAGING SYSTEM. Emergency Medical Plan 07/12/2006 TRANSPORT TO NEAREST HOSPITAL, ALSO, DOCTORS AND NURSES ON STAFF. -5- 02/06/2007 F PLEASANT CA.RE.BAKERSFIELD SiteID: 015-021-000340 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 07/12/2006 ~ OXYGEN CYLINDER CHAINED TO WALL. OXYGEN CANISTERS USED TO HOLD E (SMALL) OXYGEN TANKS. Release Containment 05/18/2006 REGULAR INSPECTION OF OXYGEN CYLINDERS; THAT THEY ARE CHAINED, SECURED, AND FREE OF LEAKS. l.1Cdi1 U~J V 1.11C1 1CC w7VUL~.:C HGLIVCLL1Vll -6- 02/06/2007 r,< r, - F PLEASANT CARE BAKERSFIELD SiteID: 015-021-000340 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards 09/13/2000 ~ 120-140 SENIORS (MANY DISABLED). Utility Shut-Offs 01/05/2007 A) GAS - N ENTR ON W SIDE OF BLDG B) ELECTRICAL - S BULLPEN W SIDE OF BLDG C) WATER - NEXT TO GAS METER W SIDE OF BLDG D) SPECIAL - NONE E) LOCK BOX - iV4 y~S Fire Protec./Avail. Water 02/06/2007 PRIVATE FIRE PROTECTION - FIRE SPRINKLERS, FIRE EXTINGUISHER, PULL BOX, AND SMOKE DETECTOR. FIRE HYDRANT - f'~E~RBP~ STATION ON Q S T . 6Y?nln`~\2 Building Occupancy Level 03/01/2006 125 EMPLOYEES -7- 02/06/2007 :~~ ~ F PLEASANT CARE BAKERSFIELD SiteID: 015-021-000340 ~ Fast Format ~ ~ Training Overall.Site ~ ~ Employee Training 05/18/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY ORIENTATION ON HIRE AND A YEARLY IN-SERVICE TO ALL STAFF ON SAFETY. rays c. Held for Future Use raciu 1.v.L ru~.ulc vac -8- 02/06/2007 UNIFIED ~ROGIZAMI INSPECTION CHECKLIST SECTION 1 Business .Plan and Inve t ~ry Program Bakersfield Fire -Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: ~ti61)_326-3979 IN CTION GATE INSPECTION TIME FACILITY NAME ~ y I J ADDRESS PHONE No No. of Empbye((e""s''~~ ---- ~ ~-~ -- ~~ ~-- ~--- --- --- ----------........__._ ._..---.._ ... __._..._ _. _._. ~~-~~~~ . ----._'_~_~l..._._.. FACILITYCONTACT Business ID Number -~-• 15-021- Section 1: Business Plan and Inventory Program ~outine D Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection C ANY HAZARDOUS WASTE ON SITE?: ^ YES ONO EXPLAIN: • QUESTIONS REGARD NG THIS INSPECTION? PLEASE CALL US AT ~66~~ 326-3979 _ __-----------.~.--------- ------ ----. ---- ----~~-¢ _.._ L.~. ---- -... - - -- Inspector (Please Print) Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow - Slatbn Copy iness ite Responsibl arty (Please Print) Pink • Business Copy ~: i + PLEASANT CARE BAKERSFIELD ___________________________ SiteID: 015-021-000340 + Manager BusPhone: (661) 327-7687 Location: 730 34TH ST Map 103 CommHaz. Low City BAKERSFIELD Grid: 19D FacUnits: 1 AOV: CommCode: BFD STA 04 SIC Code:8051 EPA Numb: DunnBrad:93-102-6009 Emergency Contact / Title Emergency Contact / Title LIN~A CRUZ / ADMINISTRATOR JORGE CHIPRES / MAINTENANCE Business Phone: (661) 327-7687x Business Phone: (661) 327-7687x 24-Hour Phone ( ) - x 24-Hour Phone (661) 329-5251x Pager Phone ( ) -, x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact Phone: (661) 327-7687x MailAddr: 730 34TH ST State: CA City BAKERSFIELD Zip 93301 Owner PLEASANT CARE BAKERSFIELD Phone: (661) 327-7687x Address 730 34TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: _ ~ Gal Certif ~ d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT ~~'' END J~f ~M ~ l ~ ~Ops ~, ~~ 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 complete. } Signature ~D/070 ~v Date -1- 05/18/2006 ~~