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HomeMy WebLinkAboutBUSINESS PLAN GLl ~ H zW w~ a ~~ ~~ aN x~ SI -.. .~ t.• ~~ HALL AMBULANCE SERVICE Manager Location: 1001 21ST ST City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: SiteID: 015-021-000907 BusPhone: (661) 327-4111 Map 103 CommHaz Extreme Grid: 30A FacUnits: 1 AOV: SIC Code:4119 DunnBrad: Emergency Contact / Title Emergency Contact / Title ~©II-IS--CI~,X_, / OPS MANAGER JOHN SURFACE / ASST OPS MGR Business Phone: (661) 322-8741x Business Phone: (661) 322-8741x 2~--~H~=~ '~--~- ;-G~s3~--~3fr 1fr8.0~ 2 4 -Hour Phone ( 6 61) ~ 7 =-4~ l~~ ~-l~Z~' ~~a.~ge~-~e~~ (_, 6 6~)8.6~~.a.-A-7 ' Pager Phone ( ) - e.(Z y x ~~~ L - G ~> Fire Press Hazmat Hazards : ~ ~C;-~('~ ~"~ ~"}C;~C-~~ ImmHlth DelHlth Contact f~ ~°Oi'~3 5-~-•-C©~G~, ~`vln ~ S ~ ~ C~u.t~ ~- Phone : ( 6 61) 3 2 7 - 4111x MailAddr: 1001 21ST ST State: CA City BAKERSFIELD Zip 93301 Owner HARVEY L HALL Phone: (661) 327-4111x Address 1001 21ST ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT in uir of those individuals LIY~ Based on my ~ y ible for obtaining the information, a c:artify JuL Zip' respons under penalty of lave that I have personally iliar w'sth the information examined and am fam submitted and believe the information is true, acc rate, and complete. `~ ~- ~ G~ ~~~~ 7 gnature pale r -~~ -~~. -1- 07/11/2007 ~ ~ F HALL AMBULANCE SERVICE ~ Hazmat Inventory ~ MCP+DailyMax Order = = SiteID: 015-021-000907 ~ By Facility Unit ~ Mobile Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP MEDICAL OXYGEN F P G 2440.00 FT3 Low -2- 07/11/2007 F HALL AMBULANCE SERVICE ~ Hazmat Inventory ~ MCP+DailyMax Order = = SiteID: 015-021-000907 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WINDOW CLEANER/AMMONIA IH DH L 55.00 GAL Ext -3- 07/11/2007 F HALL AMBULANCE SERVICE ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME MEDICAL OXYGEN Location within this Facility Unit 1031 21ST ST SiteID: 015-021-000907 ~ Facility Unit: Mobile Containers on 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 2440.00 FT3 2440.00 FT3 1220.00 FT3 riHL,HKLVUJ l.:vl°lrvlvt51v15 %Wt. RS CAS# 1.00.00 Oxygen, Compressed No 7782447 riHGHKL HSJL"~551~1iS1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P / / / Low -4- 07/11/2007 F HALL AMBULANCE SERVICE ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WINDOW CLEANER/AMMONIA Location within this Facility Unit OUTSIDE DOOR 4 STATE TYPE ~- PRESSURE Liquid TMixture I Ambient SiteID: 015-021-000907 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7664-41-7 TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 55.00 GAL 55.00 GAL 50.00 GAL 1.1r~~HxLUUS uurirulv~lv~t~~ %Wt. RS CAS# 10.00 Ammonia Solution, Conc. Less Than 20% No 1336216 tiHGFllCL A~51;551~1L'1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Ext -5- 07/11/2007 F HALL AMBULANCE SERVICE SiteID: 015-021-000907 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/06/1999 ~ THE PROPER AGENCY WILL BE NOTIFIED. Employee Notif./Evacuation 07/20/2006 IN THE EVENT OF A SPILL OR INCIDENT, AND DEPENDING ON THE NATURE, DAMAGE AND THREAT POTENTIAL, AN ORDERLY EVACUATION OF THE FACILITY WILL BE ORDERED, AND, IF INDICATED, THE PROPER AGENCY NOTIFIED. Public Notif./Evacuation 03/20/1992 IN THE EVENT OF A SPILL OR INCIDENT, AND DEPENDING UPON THE NATURE OF THAT INCIDENT, DAMAGE AND THREAT POTENTIAL, THE APPROPRIATE AGENCY WILL BE NOTIFIED TO DETERMINE IF PUBLIC NOTIFICATION AND OR EVACUATION WOULD BE WARRANTED. Emergency Medical Plan 07/20/2006 PROFESSIONS HEALTHCARE INC, 1800 WESTWIND DR 301 OR SAN JOAQUIN COMMUNITY HOSPITAL, 2615 EYE ST. -6- 07/11/2007 F HALL AMBULANCE SERVICE SiteID: 015-021-000907 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 12/06/1999 ~ MATERIAL WILL BE STORED IN THE PROPER LOCATION. Release Containment 12/06/1999 IN THE EVENT OR A RELEASE, CONTAINMENT WILL BE CONDUCTED WITH CURRENT APPLICABLE MSDS STANDARDS. Clean Up 07/20/2006 IN THE EVENT OF A SPILL, THE AREA WILL BE FLUSHED WITH LARGE AMOUNTS OF WATER INTO A DRAIN IN ACCORDANCE WITH THE MSDS. Other Resource Activation 07/20/2006 IN THE EVENT OF AN ONSITE INCIDENT, THE ON-DUTY FIELD SUPERVISOR AND ®PEi~T~~'~fA~.VA~~`R WILL BE NOTIFIED AND WILL RESPOND TO THE SCENE . -7- 07/11/2007 F HALL AMBULANCE SERVICE SiteID: 015-021-000907 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~Nc~:lal na~aiua Utility Shut-Offs A) GAS - S SIDE OF BLDG REAR B) ELECTRICAL - W SIDE OF BLDG SW CRNR C) WATER - S SIDE OF CREW QTRS D) SPECIAL - NONE E) LOCK BOX - NO 01/31/2007 Fire Protec./Avail. Water PRIVATE FIRE PROTECTION: AUTOMATIC SPRINKLER SYSTEM AND ABC FIRE EXTINGUISHERS. FIRE HYDRANT - NW SIDE OF BLDG AND NE CRNR 21ST & N ST. 07/20/2006 Building Occupancy Level 07/20/2006 30-35 EMPLOYEES -8- 07/11/2007 F HALL AMBULANCE SERVICE SiteID: 015-021-000907 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 11/21/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: THE OUTLINE PROCEDURES FOR HANDLING HAZARDOUS MATERIALS IS OUTLINED IN THE EMPLOYEE MANUAL. EACH EMPLOYEE IS RESPONSIBLE FOR KNOWING THE INFORMATION CONTAINED IN THE MANUAL, AS EACH EMPLOYEE SIGNS AN ACKNOWLEDGEMENT OF UNDERSTANDING. rayc ~ nciu tvi ruLULC u5~ nc~.u ivt ru~.uiC uac -9- 07/11/2007 + HALL AMBULANCE SERVICE _==___________________________ SiteID: 015-021-000907 + Manager BusPhone: (661) 327-4111 Location: 1001 21ST ST Map 103 CommHaz Extreme City BAKERSFIELD Grid: 30A FacUnits: 1 AOV: CommCode: BFD STA O1 SIC Code:4119 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title LOUIS COX / OPERATIONS MGR JOHN SURFACE / ASST OP MGR Business Phone: (661) 322.-8741x Business Phone: (661) 322-8741x 24-Hour Phone (661) 836-1680x 24-Hour Phone (661) 327-4111x Pager Phone (661) 863'-1107x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact Phone: (661) 327-4111x MailAddr: 1001 21ST ST State: CA City BAKERSFIELD Zip 93301 Owner HARVEY L HALL Phone: (661) 327-4111x Address 1001 21ST ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~ D O`~ BTU JUL 2 0 2006 ~~ ~~ 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, ~?~'a ~ Date -1- 02/27/2006 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business ,Plan and Inventory Program Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 933~C Tel: (661)_326-3979 _ _ _'S7Q©~r FACILITY NAME INSPECTI N DATE INSPECTION TIME 0 o a ADDRESS (ov I Z- ~'~" 5`~ ~ - PHONE o. No. of Employees ~Zz 8?`~ i ~6 ---------- -. -----_ -------- - - FACILITYCONTACT Business ID Number ly u t 5 COX 15-021- t~ ~ o "7 Section 1: Business Plan and Inventory Program Routine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection • ANY HAZARDOUS WASTE ON SITE7: Q YES ~NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~G6'I ~ 326-397 --- ---~~-~- ._~_ a~ - --- . _-----.--- _ ----~-~--- -_-- In t:tor Please Pnnt Fire Prevention 1st-INShift of Site White • Environmental Services Yellow -Station Copy --~ Business Site Responsible Party (Please Pn rn 8 Pink -Business Copy 4~~`~ -`'~~ CITY OF BAKERSFIELD F1RE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES ,~pp3 ~ ~ ~~ UNIFIED PROGRAM INSPECTION CHECKLIST v `~ `w ~~ti,~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 ~~ I FACILITY NAME i-lc,.u t~rr~ •ic~rLe [NSPECTION DATE 10 l~9 ~a3 _ ADDRESS toot z~ sue- s~~ PHONE NO. 3 a.~ - ~~t r FACILITY CONTACT t_c~~~.s ~~~' - BUSINESS ID NO. IS-21U- n is -oa.t -aoo9a~ INSPECTION TIME tv NUMBER OF EMPLOYEES 70 Section 1: Business Plan and Inventory Program outine ^ Combined ^ Joint Agency ^Minti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate ~ Visible address Correct occupancy Verification of inventory materia{s Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Naz Mat training Verification of abatement supplies and procedures Emergency procedures adequate /~ Containers properly labeled Housekeeping It ~ ~~~ /~/jyj p ~ 7 Fire Protection '~ ~~~ e-.se'< ee,.aa -c'o esT~ Site Diagram Adequate & On Nand ~"' C=Compliance V=Violation Any hazardous waste on site?: ^ Yes ~'No Explain: Questions regarding this inspection? Please call us at (661) 326-3979 White -Env. Svcs. Yellow -Station Copy Pink -Business Copy ~ 1 ~,- Business Site Responsible P y Inspector: , t