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Home My WebLink AboutBUSINESS PLAN_1201 24THa L ~2 pl otf N ~ N m C In - ;. .~ SAN~'JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 Manager STEVEN BOOTH Location: 1201 24TH ST B-200 City BAKERSFIELD BusPhone: (661) 324-4431 Map 103 CommHaz Minimal Grid: 30A FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: SIC Code:8041 DunnBrad:77-045-3785 Emergency Contact / Title Emergency Contact / Title DR TOMAS RIGS / OWNER DR STEVEN BOOTH / OWNER Business Phone: (661) 324-4431x Business Phone: (661) 324-4431x 24-Hour Phone (661) 321-8131x 24-Hour Phone (661) 872-7118x Pager Phone (661) 549-1182x Pager Phone (661) 703-7070x Hazmat Hazards: React Contact STEVEN BOOTH Phone: (661) 324-4431x MailAddr: 1201 24TH ST B-200 State: CA City BAKERSFIELD Zip 93301 Owner TOMAS RIOS & STEVEN BOOTH Phone: (661) 324-4431x Address 1201 24TH ST B-200 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~"~ ~ t~~~ ~~~~ C~avc~d on my inquiry of those individuals - reai~c~ns~!e tc~r Ui~fairiir~ the intc~rmation, I certify un~~cr ~;en aity o? iav~ that I h<;ve personally eyamired and am tam'siiar iNith the information sr~;3rlittac4 ^.nd `7e;lieve the information is true, accurate . ind complete. ~ / N D~ ... ~ _ _ igna4ure to -1- 07/16/2007 T' F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... TpecHaz EPA Hazards) Frm I DailyMax IUnitIMCP) WASTE FIXER R L 3.00 GAL Minl -2- 07/16/2007 -3- 07/16/2007 4 F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ ~ 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:. X-RAY DARKROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste ~ Ambient ~ Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 3.00 GAL 3.00 GAL 3.00 GAL - HAZARDOUS COMPONENTS aWt. RS CAS# Silver No 7440224 ri1~GAtCL AS~~J~1~11;1V'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R % / / Min -4- 07/16/2007 F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/13/2000 ~ TRAY UNDER COLLECTION BOTTLE. Employee Notif./Evacuation 05/22/2006 HAZMAT, 911, OFFICE OF EMERGENCY SERVICES 800-852-7550 (EMERGENCY) AND OFFICE OF ENVIRONMENTAL SERVICES 326-3979 (NON-EMERGENCY). Public Notif./Evacuation 12/13/2000 DR BOOTH AND/OR DR RIGS. P~ILICLyC11C:y 1"1CU1Ud1 Y1dil -5- 07/16/2007 ,. ~. F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 12/13/2000 ~ PERIODIC INSPECTION. Release Containment 12/13/2000 TRAY UNDER COLLECTION BOTTLE. Clean Up 12/13/2000 SPILL KIT. v~.iic1 nc~vui~.c 1-~1:1.1VGtl.1V11 -6- 07/16/2007 .v F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JCC:1d1 I1dGd.l U.7- Utility Shut-Offs 04/18/2007 GAS - E SIDE OF BLDG ELECTRICAL - BREAKER BOX E SIDE DARKROOM WATER - E SIDE OF BLDG Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - ALLEY E SIDE OF BLDG. 05/22/2006 Building Occupancy Level 1 EMPLOYEE 05/22/2006 -7- 07/16/2007 ,~ _. F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/22/2006 ~ MSDS SHEET ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: NOTIFICATION OF FIRE EXTINGUISHERS AND ESCAPE PLAN. rayc ~ nciu tUi rul. uLC USC nclu 1vL rul.uLC U5C -8- 07/16/2007 '~„ .r'?y~- _ °*:'~-`v i.~ ,r ar~ ~r~ `~y~."'-..,. yr_ "'` ,.- :,-+;:7'- J sz=. i.+ .r ,_,.~~,. _r~=v ^=~:~ .d' ~ ;~.. .Yr ~~~ k ~r-n::^m.. "+f ^)ra~' - ~ , ' , • 3s BAKERSFIELD FIRE DEPT. ~~~~ ~ B E >z s F , ~ "D Prevention. Services ~ , .FIRE PREVENTION. INSPECTION` P/RE 900 Truxtun Ave:, Ste. 210 ARTM T Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ Fax:, (66':1) 852-2171 ' a,+ DISTRICT BLOCK NO. DATE ~ t J ,, EE ~~ ~~ ~ r ~~ f FACILITY ADDRESS ~p `` +{ -."~"4 # ~ ~ ~ CITY, STATE, ZIP " ;p ~ ("' -1' ~ ~ ~ ~r ~ . . FACILITY NAME-_ '"~:' ~ ~ ~ ~ ~-' ~ ~ ~ ~- ~ ~MANAGER'SNAME• ~~ ~ ~ ~ FACILITYPHONE.NO~~~; BUSINESS OWNER'S NAME AND ADDRESS ~ ~' ~ ~ ~ ~ CITY, STATE, ZIP. ~ ~ OWNER'S PHONE N0. BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS ~ ~ . ' CITY, STATE, ZIP,-. .. ~ BILL'INGPHONE NO." OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISER DATE . ^' YES ^ NO CORRECT~ALL VIOLATIONS vwunoe ~ - ~ ~, ~ REQUIREMENTS - ~~ ~ ~ ~ ~~, /„-. CHECKED BELOW so. t~/ COMBUSTIBLE WASTE'I DRY 1~ Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) , vEGETAT1oN - ~ ~ ~ 2 ~ Provide non-combustible containers with tight fitting lids for'the storage of combustible waste-a'nd rubbish pendirig-its safe disposal (U.F.C.). COMBUSTIBLE STORAGE 3 Relocate combustible.s(orage to provide at least 3 feet clearance around motor fuse box/fire door (N.E.C.) (U:F.C.) 4 Relocate fire extinguisher(s) so that they will be in a.conspicuous location, hanging on brackets with the, top to the extinguisher not more than 5 feet above the floor. (N.F.P.A. No. 10) EXTINGUISHERS 5 Provide and install (amount) _____ approved (type 8 size) __________________ portable fire extinguisher to be immediately accessible for use in (area) __ _______________ (U.F.C.) ' g Re; charge alt fire extinguishers. Fire extinguishers shall be serviced at least once-each year, andlor after each use, by a person having a valid licerise or.certificate. (U:F.C:), ' 7 Provide and maintain "EXIT" sign(s) with letters 5 ormore inches in height.oyer each required exit (door/window) to' SIGNS fire escape. (U: F. C.) , g Provide and maintain appropriate. numbers on a contrasting background and visible from the street to indicate. the correct address of the building. (B. M.C.) (U.F.C.) ' . i g _ Repair all (crackslholeslopenings) in plaster in (location) ______________________________________. Plastering. F.IREDOORSI ~ - - FIRE EPARATIONS _ .shall return the surface to its original fire resistive condition. (U.B.C.) ~ - ~~ ~ - ~. ~ ~ - S 10 - Remove/repair (item & location) ___ g __ ~_ _______________ .__________. Self-closing doors shall be designed to close by gt~,~r~i~~aL~on of a rrlechanical device, or by an approved smoke and 'heat sensitive device. Self-closing doors shall have'no attachments capable of preventing ttie operation of the closing device. (U.F.C.) EXITS 11 Remove all obstruction from hallways. Maintain.all'means of egress free of any. storage: (U. F.C.) • . 12 Provide a contrasting colored and permanently installed electric light over dr near required exit:(location) , _________ to clearly indicate it as an exit. (U. F: G.) STORAGE ~ - 13 Remove all storage and/,or other obstructions from fire escape landings and stairways stair shafts. (Fire - escapes/stair shafts are to be maintained free from obstructions at all times.). (U.F.C.) -, . 14 Extension cords shall not be used in lieu of permanent approved wiring., Install additional approved. electrical outlets ELECTRICAL APPLIANCES ~ where-needed. (N. E. C.) (U. F. C.) t5 .Remove multiple attachment cords from.specific'electrical ,convenience outlet (one plug per outlet) (N.E.C.) (U.F.C.) OUTDOOR BURNING 16 ~ Violation~of Section.1102 dealin with recreational fires or o en burnin ~ U.F.C. ~ ~ ~ ~ ~ ~ ' FIREWORKS 17 Violations of Section 7802 . U.F. . or C 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks. OTHER ~ ~ y 18., ~ q ! F ) - x~ .~*~";.} , ~ 1n E ~ A . 'Y"?"._ t -~ i ' e:s ..... ~....r r~. i ~ tk.d" C. ~ .. ivs' _. . _a . .y ,,,. ,. .l c^ // CUSTOMER: ~!,~p"'T~ t ~fe~ ~sC~`;!~` ,x :R : 'LEGEND: . . . ' (Si nature) (Please Print Name Le ibl Tlt~ ~ G.F..C. CALIFORNIA FIRE CODE ' g . y, g e), . f U.B.C: UNIFORM BUILDING CODE ~, ~ i INSPECTOR: ~ ~~'-'''-~ *-. ~ AP NO.: '~ ° ^-~i , B:M.C. BAKERSFIELD MUNICIPAL CODE. -. N:F.P.A. NATIONAL'fIRE_PROTECTION '' (SlgnatUre) ASSOCIATION N.E.C. NATIONAL ELECTRIC CODE ' White -Customer/Original Yellow -Station Copy Pink- Prevention Services F~ 2022 (ReV. 09/05) , S~1N JOAQUIN WELLNESS & MED GRP ~ SiteID: ~_ ._ 015-021-002167 Manager :ST~~ u.o BusPhone: (661) 324-4431 Location: 1201 24TH ST B-200 Map 103 CommHaz Minimal City BAKERSFIELD Grid: 30A FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:8041 DunnBrad:77-045-3785 Emergency Contact / Title Emergency Contact / Title DR TOMAS RIOS / OWNER DR STEVEN BOOTH / OWNER Business Phone: (661) 324-4431x Business Phone: (661) 324-4431x 24-Hour Phone (661} 321-8131x 24-Hour Phone (661) 872-7118x Pager Phone (661) 549-1182x Pager Phone (661) 703-7070x Hazmat Hazards: React Contact ~ 6~5 %S Phone: (661) 324-4431x MailAddr: 1201 24TH ST B-200 State: CA City BAKERSFIELD Zip 93301 Owner TOMAS RIOS & STEVEN BOOTH Phone: (661) 324-4431x Address 1201 24TH ST B-200 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 ~ ~ ENT p ~ P R ~ ~ ~Q07 [3aaed on my inquiry of these individuais responsible for attaining the inform,~tion, i certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurat a comp .t . ('l e 1 " O~ ~ 1//SI nalUre Oate' -1- 02/06/2007 F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 3.00 GAL Min -2- 02/06/2007 -3- 02/06/2007 F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ ~ 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: X-RAY DARKROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 3.00 GAL 3.00 GAL 3.00 GAL HAZARDOUS COMPONENTS %Wt• RS CAS# Silver No 7440224 -- L1tiGtiiCL HJ JP~.7.71"1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/06/2007 F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/13/2000 ~ TRAY UNDER COLLECTION BOTTLE. Employee Notif./Evacuation 05/22/2006 HAZMAT, 911, OFFICE OF EMERGENCY SERVICES 800-852-7550 (EMERGENCY) AND OFFICE OF ENVIRONMENTAL SERVICES 326-3979 (NON-EMERGENCY). Public Notif./Evacuation 12/13/2000 DR BOOTH AND/OR DR RIOS. r~u~ciycii~.y i•icui~:ai rialt -5- 02/06/2007 F S.~N JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 12/13/2000 ~ PERIODIC INSPECTION. Release Containment 12/13/2000 TRAY UNDER COLLECTION BOTTLE. Clean Up 12/13/2000 SPILL KIT. vl.iict itGw7 Vl.Lt VG t11: 1.1 VCL l.1 V11 -6- 02/06/2007 F SP,N JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JCC:1d1 11dGdI U5 Utility Shut-Offs A) GAS - E SIDE OF BLDG B) ELECTRICAL - BREAKER BOX E SIDE DARKROOM C) WATER - E SIDE OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO 05/22/2006 Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - ALLEY E SIDE OF BLDG. 05/22/2006 Building Occupancy Level 05/22/2006 1 EMPLOYEE -7- 02/06/2007 F SAN JOAQUIN WELLNESS & MED GRP SiteID: 015-021-002167 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/22/2006 ~ MSDS SHEET ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: NOTIFICATION OF FIRE EXTINGUISHERS AND ESCAPE PLAN. t'dyC G Held for Future Use nciu ivi r u~.utc vac -8- 02/06/2007 + SAN JOAQUIN WELLNESS & MEDICAL GR ___________________ SiteID: 015-021-002167 + Manager '~~ ~,r,-~ ~~ BusPhone: (661) 324-4431 Location:--r~~ ~ ~l~ ~r `'~ Map 102 CommHaz Minimal City BAKERSFIELD Sv~`~°2 $ -`Z00 Grid: 25B FacUnits: 1 AOV: CommCode: BFD STA O1 SIC Code:8041 EPA Numb: DunnBrad:77-045-3785 +______________________________________________________________________________t ------------- ----------------- - --------- --------------------------- Emergency Contact / ~ Title Emergency Contact / Title DR TOMAS RIGS / OWNER DR STEVEN BOOTH / OWNER Business Phone: (661) 324-4431x Business Phone: (661) 324-4431x 24-Hour Phone (661) 321-8131x 24-Hour Phone (661) 872-7118x Pager Phone (661) 549-1182x Pager Phone (661) 703-7070x Hazmat Hazards: React -- ------------------------------------------- Contact 17Q~ ~t-('fi'` ~`~~~C'~~ Phone: (661) 324-4431x MailAddr: -~_ .?moo State: CA City BAKERSFIELD Zip 93301 Owner TOMAS RIOS & STEVEN BOOTH fz Phone: (661) 324-4431x Address ~ a~~ '" ""' ST ~~~ Zt~~. ~'~~ ~/ ~O State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~ ~ 1 / ~~®~ PROG H - HAZ WASTE GEN ~~ ~ 6v ~~ o~ ~ ~~C 55 ENT'D Mq y 31200 6 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 famlllar with the information submitted and believe th® information is true, accurate, and com late. ig r Da -1- 05/22/2006 ~4= ~' '' Prevention Services <r.,.. ~.;,. UNIFIED PROGRAM INSPECTION CHECKLIST ' e A R s F , n 9ooTruxtun Ave., Suite 210 FARE' Bakersfield; CA 93301 , SECTION 1: Business Plan and Inventory Program _ i°RT"' Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSP CTIO DATE INSPECTION TIME ADDRESS `'_ 12n 1 IT ~$ ~ 2c~c~ PHONE ~N,,]Q. / - ~7-~J O OF EMPLOYEES g . FACILITY CONTACT -. BUSINESS ID NUMBER 15-021-4'~S ~ c~Z 1 - O Section 1: Business Plan andlnventory 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 ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~~ Y' Q. V ^ PROPER SEGREGATION OF MATERIAL ~ ^ VERIFICATION OF MSDS AVAILABILITY \ `6tl ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ~~~~~ ~~s ~r~'-_ S~ sr wa ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND '~~~ ANY HAZARDOUS WASTE ON ITE? YES ^ NO EXPLAIN: ~ ~ `~ ~S~ °j^ QUESTIONS~REGARDING TH{S {NSPECT{ON? PLEASE CALL US AT (661) 326-3979 ~ r Inspector (Please Print) Fire Prevention / 1s' In /Shift of Site/Station # Business Site /Responsible Party (Please Print) 3~v~1 _ _ - White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ~~ ` J FACILITY NAM Section 4: Ha ^ Routine ~ g OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~ cL „~, -j- Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurcence 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 fi,/ Secondary containment provided Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste Proper management of lead acid batteries including labels N ~~ Proper management of used oil filters '~ Transports hazardous waste with completed manifest j Sends manifest copies to DTSC Retains manifests for 3 years ~ _ ~~ Sc~l w JY Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years ~ ~ Determines if waste is restricted from land disposal C=Compliance V=Violation Inspector: ~ ~ y'a'k--~^-~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. /~~4~`. ~T~`>" CITY OF BAI~ERSFIELD FIRE DEPARTMENT ~d ~~ OFFICE OF ENVIRONMENTAL SERVICES ~° •y UNIFIED PROGRAM INSPECTION CHECKLIST r, _~ ~~~ 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 E S a +` 5aa ~.~ ~ -~ G~~~~ ~ ~. S c INSPECTION DATE S / 9 (° 7 zardous Waste Generator Program EPA ID # ~ ~`~ `^~cS' ~' Combined ^ Joint A ency ^Multl-Agency ^ Complaint ^ Re-inspection Business Site Responsible Party Pink -Business Copy