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Ivl~ FREED & GAPPER DDS SiteID: 015-021-002329 Manager Ric-~-~D GQrpP~ ap5 , Location: 1735 28TH ST City BAKERSFIELD BusPhone: (661) 322-8815 Map 102 CommHaz Minimal Grid: 24D FaCUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title H KATHLEEN FREED / DDS ~/t4~-. tN~s t~"r RICHARD L GAPPER / DDS f'+"~y~~~-~" Business Phone: (661) 322-8815x Business Phone: (661) 322-8815x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone (661) 304-3233x Hazmat Hazards: React Contact RICHARD L GAPPER DDS Phone: (661) 322-8815x MailAddr: 1735 28TH ST State: CA City BAKERSF IELD Zip 93301 Owner FREED & GAPPER DDS Phone: (661) 322-8815x Address 1735 28TH ST State: CA City BAKERSFIELD Zip 93301 Period /-J-D6 to.~-/-07 Preparer : 'i~cc.~+~n-fl 6A-pP~ Certif'd: ParcelNo: TotalASTs: _ TotalUSTs: _ RSs: No 7~~ Ga 1 Gal Emergency Directives: PROG H - HAZ WASTE GEN Based on my inquiry of those 'tndivlduals 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. ~ ~ L-S'-D 7 Signature Date ~~nig ~N~'~ MAR ~ ~ ~QQ~ -1- 01/31/2007 F FREED & GAPPER DDS = ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-002329 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 5.00 GAL Min cC ~~ P,~~p ~,~ ©~y .,9C-~q.~y S'"J~-VT'ioN5 Cc~MP+~-nay wt}r~v ice- .S O/-~uUw c~J•vr-9-r~v~~ ~5 Ft~u , -2- 01/31/2007 -3- 01/31/2007 F FREED & GAPPER DDS SiteID: 015-021-002329 ~ ~ 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: DARKROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL t1HGKKLV UJ 1:V1~lYV1VL' 1V l ~Wt. RS CAS# Silver No 7440224 riE~GL~tCL L~~~1;5~1~1L'1V1-5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 01/31/2007 F FREED & GAPPER DDS SiteID: 015-021-002329 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ r_ Cly Glll.. 2. 1YV 1..1111.a V 1V11 /~ Ldll~llVyCC 1VV 1~11~.GVdl:Udl.1 V11 Pvs-za Njn~ 5 ~s~ ~x r ~'S ,_ rW.J111: 1VV l..Ll ~ LiV dl.:Udl.1 V11 ~»~ ~ ~~ (moo>r~ ~x - ~-S emergency Medical Plan -5- 01/31/2007 F FREED & GAPPER DDS SiteID: 015-021-002329 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention Other Resource Activation -6- 01/31/2007 F FREED & GAPPER DDS SiteID: 015-021-002329 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aNC~:la.i na~aLU~ Vl.1.L11.y .711U 1,-VLLw7 ~~ GA ~ ,_ . riLC rLV~G~:. ~t1Va.ii. YVGtI.CL DU11\Allly VV~. U~JQlll.y J.JCVC.L W ;~... N ~ ~/,s..z. 1-~-~ v F Mon-e._ ~-N-+9-N ZO p~o~2.c ~ .-~ 7r~.~ F/~-v r~ y-''t' -7- 01/31/2007 %. ~` "e.-~ F FREED &-~GAPPER DDS SiteID: 015-021-002329 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training ~~ R-r i }h rL-t >v ~ GtTr D ~-~~ rayc ~ Held for Future Use Held for Future Use -8- 01/31/2007 . _ ~ ~t~~o - -. UNIFIED PROGRAM INSPECTION CHECKLIST ' ~~~~' Prevention Services B :, F R s F t n 900 Truxtun, Ave., Suite 210 v,rRF - -- Bakersfield, CA 93301 SECTLON 1: Business Plan and Inventory Program "R"" Tel.:. (661) 326-3979, Fax: (661) 872-2171 FACILITY NAME ~ //'~') ~~ //'`' ~ \c-G F+~ ~, l.~ ~~ ~ .~-~ INS~CTI ~AT O - INSPECTION TIME ADDRESS ,}~+ - ~ "1 3 S 2 0 r ~' PHO~7NE NO.'~'Q 327, ' Oo ~S NO OF EMPLOYEES - °~ FACILITY CONTACT BUSINESS ID NUMBER ^ ~ ~ /~J j'/"/ I- [' ' 15-021- / { v a Section 1: Business Plan and Inventory Program ~ ^ ROUTINE '~1 COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIrI@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS `[3 ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ~~ ^ VERIFICATION OF MSDS AVAILABILITY Q ~ ~~~I VI ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ ~ HOUSEKEEPING ~Y ^ FIRE PROTECTION ~°' ` ~ ~,.. ~~ . ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON~ITE? ~+YES ^ NO EXPLAIN: ~ Qb~-t. ~k' °`- QUESTIONS REGARDING THIS INSPECTION? -PLease cAt_t_ us AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1s'°In /Shift of Site/Station # Business Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy ~ ~ FD 2155 (Rev. 09/05 .,~_ _ _ _,,~. -_ _•3 D F ~`~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES b y UNIFIED PROGRAM INSPECTION CHECKLIST w ~gti pj~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 ~a ....a,,.. FACILITY NAME 'C ~-~ ~ G' ~ ~ Q~ ~ a1?S INSPECTION DATE -~/ 2,~, Section 4: Hazardous Waste Generator Program EPA ID # ~~x£ ~^-P~" ^ Routine ''L~l Combined ^ Joint Agency ^Multf-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number X cL i,~, 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 Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste /~ Jam, Proper management of lead acid batteries including labels /~ ~ Proper management of used oil filters Nl~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC ~ , p~~ v1 ~~. ~~~ Retains manifests for 3 years Retains hazazdous waste analysis for 3 years Retains copies of used oil receipts for 3 years ~ ~ Determines if waste is restricted from land disposal L=c:ompnance w~=vtotat~on Inspector: G FG ~-- Jl--o Office of Environmental Services (661) 326-3979 White -Env. Svcs. Pink -Business Copy Business Site Responsible Party