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Home My WebLink AboutBUSINESS PLAN~ . ~ SO WEST ~ OSPITAL --- -- -- -2905 BRUNDAGE -LANE - ~ ^ ^L -- - - ~ 7.~ SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 Manager DR ANDERSON Location: 2905 BRUNDAGE LN City BAKERSFIELD BusPhone: (661) 327-5719 Map 123 CommHaz Low Grid: OlA FacUnits: 1 AOV: CommCode:_BFD STA 03 EPA Numb: SIC Code:0742 DunnBrad: Emergency Contact / Title Emergency Contact / Title DR ANDERSON / DOCTOR MARK HOLLAND / DOCTOR Business Phone: (661) 327-5719x Business Phone: (661) 327-5719x 24-Hour Phone (661) 665-9732x 24-Hour Phone (661) 665-9934x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact DR ANDERSON Phone: (661) 327-5719x MailAddr: 2905 BRUNDAGE LN State: CA City BAKERSFIELD Zip 93304 Owner DR ANDERSON Phone: (661) 327-5719x Address 2905 BRUNDAGE LN State: CA City BAKERSFIELD Zip 93304 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN Ct~~o u~ ~ ~ Oased o z0a~ n my inquiry of those individuals feGpv~nsibie for ohtaininy the information under Denalt 6 Certif , y y o? ia~~ that I have persor?ally examined and am familiar with th i b e su nformation mitted anc~ 17~Haye the information is true accurate and c , , omplete. Sig afore Date -1- 07/16/2007 ;, ,, F SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN F IH DH G 500.00 FT3 Low WASTE PHOTOGRAPHIC FIXER & DEVE DH L 5.00 GAL UnR -2- 07/16/2007 ~~' Z ~ -3- 07/16/2007 F SOUTHWEST VETERINARY HOSPITAL ~ Inventory Item 0001 ~ COMMON NAME / CHEMICAL NAME I OXYGEN Location within this Facility Unit INSIDE NE CRNR OF OPERATING ROOM SiteID: 015-021-002246 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE = Gas TPure ~-Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 249.00 FT3 500.00 FT3 500.00 FT3 tiE~GAtCLVU~ ~vt~lrvlvJ;lv1~ %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 t1AGE~KL 1-1a51';5~1~11";1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE PHOTOGRAPHIC FIXER & DEVELOPER Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE DARKROOM/X-RAY ROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# TTT ATTTI T!'1 lTT1lT /1T lT~ITTT /T l1tiGlitCL L-iJ JP~J JITIP..,1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / UnR -4- 07/16/2007 F SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification _, t ~~ t,u~NlvyCC ivv~.ii . ~ ~va~ua~ivls Public Notif./Evacuation rtltCLyC11Uy 1"1CU1C:d1 Y1di1 -5- 07/16/2007 s . F SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ LCC1CG1 s~"C t"I.CVCll l.1 U11 Release Containment t.l CGL11 V~l Other Resource Activation -6- 07/16/2007 e~ ~. F SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aNc~,iai nac.aiu~ ~ _ .r i___~ .. r_r v~.iii~.y aiiu~.-Viii r1LC t'LVI..CC:. /L-1Vd11. WdLCt Building Occupancy Level 12/07/2006 22 EMPLOYEES -7- 07/16/2007 `A. ~i l > F SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ Fast Format ~ ~ Training Overall Site ~ 1:+lll~JlVyGG 110.111111y rayC a nclu 1_vt rul,utC Uac 11G 111 1V1 1'ul.uiC U.7'C -8- 07/16/2007 SOUTHWEST VETERINARY HOSPITAL Manager Location: 2905 BRUNDAGE LN City BAKERSFIELD CommCode: BFD STA 03 EPA Numb: SiteID: 015-021-002246 BusPhone: (661) 327-5719 Map 123 CommHaz Low Grid: OlA FacUnits: 1 AOV: SIC Code:0742 DunnBrad: Emergency Contact / Title Emergency Contact / Title DR ANDERSON / DOCTOR MARK HOLLAND / DOCTOR Business Phone: (661) 327-5719x Business Phone: (661) 327-5719x 24-Hour Phone (661) 665-9732x 24-Hour Phone (661) S3~Fa `_~~ Pager Phone ( ) - x Pager Phone ~ ( )~~'S ~34x Hazmat Hazards: Fire ImmHlth DelHlth Contact DR ANDERSON Phone: (661) 327-5719x MailAddr: 2905 BRUNDAGE LN State: CA City BAKERSFIELD Zip 93304 Owner DR ANDERSON Phone: (661) 327-5719x Address 2905 BRUNDAGE LN State: CA -City BAKERSFIELD Zip 93304 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN pp~~ @@ ~1~~ ~~ !a ~ qfl ~ ~*4!~~ Ei,as~d on my inquiry of those individuals the informatson, I ~~rti#y i rg re5rc:-ss;~!° fcr obta;n nder pen?.lty of lays that i have persar~aliy n ti u o xamined and am farniliar with the Informa e suer, tt_ d and behave the information is true, acc rate and co ie ... 7 y ~ .Q -~ ~ Date Sigr azure -1- 02/06/2007 ~ SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... OXYGEN WASTE PHOTOGRAPHIC FIXER & DEVE SpecHaz EPA Hazards Frm F IH DH G DH L DailyMax Unit MCP 500.00 FT3 Low 5.00 GAL UnR -2- 02/06/2007 GOOZ/90/ZO -£- .~ SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: "Grid: INSIDE NE CRNR OF OPERATING ROOM CAS# 7782-44-7 ~GasATE T TYPE T PRESSURE TEMPERATURE CONTAINER TYPE I Pure I Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 249.00 FT3 500.00 FT3 500.00 FT3 nt~,~tircLVU~ ~vinrulv~ivl~ 100.00 Oxygen, Compressed No 7782447 tiAGHtCL Ha~r;~51~1r;1V-1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low r ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME WASTE PHOTOGRAPHIC FIXER & DEVELOPER Location within this Facility Unit INSIDE DARKROOM/X-RAY ROOM Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste -~mbient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL - _ __ _ 5."00 GAL 5.00 GAL %Wt. HAZARDOUS COMPONENTS RSA CAS# HAZARD AS SESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / UnR -4- 02/06/2007 ~ SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification Employee Notif./Evacuation _I ruolic ivoLiz.~~vacuation ~uiciy~iic:y i~i~uic:cLi rlan -5- 02/06/2007 F SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ nclca~c ricvcil~lvit Release Containment dean up V1..11C1 ttCSUUic.~ 1-~C:L1vazlon -6- 02/06/2007 ~~ SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .71JCC:1d1 ndr.dius = Utility Shut-Offs ,. i~ iic riv~.c~... ~ r~vaii . vva~.ct Building Occupancy Level 12/07/2006 22 EMPLOYEES -7- 02/06/2007 ~ SOUTHWEST VETERINARY HOSPITAL SiteID: 015-021-002246 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training Held for Future Use -s- 02/06/200 UNIFIED PROGRAM INSPECTION CHECKLIST" __~ _..._ . _ _____..._ ~ _ _.._.___~_____. ~_ P .~ _ . _ _ SECTION 1: Business Plan and Inventory Program Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 s easFt n -- ___ F/RE ARTM T FACILITY NAME / INSPECTION DATE INSPECTION TIME \ ADDRESS 205 ~ PHONE O. '327-57 NO OFEMPLOYEES '~- FACILITY CONTACT ~/~^' ~o1A USINESS ID NUMBE 15-021- ~ p 22,6 ~ ~~ :...Section 1: Business Plan. and Inventory Program "I "t ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION • C V ~ C=Compliance OPERATION V=Violation COMMENTS I~^ APPROPRIATE PERMIT ON HAND ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ,., /~ L1A' ^ VISIBLE ADDRESS r C~ ^ CORRECT OCCUPANCY 2Uo6 v ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~, /~ ~Y ^ VERIFICATION OF LOCATION 'Ivy ^ PROPER SEGREGATION OF MATERIAL `` '6 d' ^ VERIFICATION OF MSDS AVAILABILITY S ~ LJeF' ^ VERIFICATION OF HAZ MAT TRAINING '~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES IC/ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN YES ^ NO nnroui QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspec or (Please Print) ire P evention / 1s' In /Shift of Site/Station # mess ite /Responsible Party (Please Print) ~~~,~z~ White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ->> - + SOUTHWEST VETERINARY HOSPITAL _______________________ SiteID: 015-021-002246 + Manager Location: 2905 BRUNDAGE LN City BAKERSFIELD BusPhone: (661) 327-5719 Map 123 CommHaz Low Grid: OlA FacUnits: 1 AOV: CommCode: BFD STA 03 EPA Numb: SIC Code:0742 DunnBrad: +______________________________________________________________________________t Emergency Contact / Title Emergency Contact / Title DR ANDERSON / DOCTOR MARK HOLLAND / DOCTOR Business Phone: (661) 32T-5719x Business Phone: (661) 327-5719x X536- 24-Hour Phone (661) 665-9732x 24-Hour Phone (661) GGx ~Ztl Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth _DelHlth Contact DR ANDERSON Phone: (661) 327-5719x MailAddr: 2905 BRUNDAGE LNr State: CA City BAKERSFIELD Zip 93304 Owner DR ANDERSON Phone: (661) 327-5719x Address 2905 BRUNDAGE LN State: CA City BAKERSFIELD Zip 93304 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParCelNo': Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN Based on my inquiry of those individuals responsible for obtaining the information, I ce~tify under penalty of law that I have personally examined and am amiliar with the information sub d and b Ii ve 4he information is true, carat ,and co pl te. 3 /3 Date ~~r~ ~ . ~~ ~"~ 2QO~ -1- 03/02/2006 UNIFIE® PROGR~-M INSPECTION CHECKLIST ~~~~ SECTION 1 Business .Plan and Inventory Program - Bakersfield Fire Dept. ' Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661) 326-3979 FACILITY NAME ,- f INSPECTION DATE INSPECTION TIME ADDRESS -------~(Q 5_. ___ - - --- FACILITYCONTACT .~rl L~~ Zl Z f- V PHONE No. ?~_ S7! Business ID Number I 15-021 No. of Employees ~ ~-- --- --- - (~022~, Section 1: Business Plan and Inventory Program ~ Routine O Combined O Joint Agency OMulti-Agency ~ Complaint O Re-inspection ANY HAZARDOUS WASTE ON SITE?: YES ^ NO EXPLAIN: • QUESTIONS REGARDING THHIS INSPECTION? PLEASE CALL US AT ~GG'I ~ 326-3979 Inspector (Please Print) ~ Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow -Station Copy e Responsible Pally (Please Print) Pink -Business Copy