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HomeMy WebLinkAboutBUSINESS PLAN 5/15/2006N I ~ ~ .u N = OI A MI ap 4 .-~ . ~ d •-, v t _u ~\~ s.,.._ . + BANDUCCI DDS MICHAEL A ______________________________ SiteID: 015-021-002339 + Manager Location: 1711. 30TH ST City BAKERSFIELD BusPhone: (661) 324-3783 Map 102 CommHaz Minimal Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA 01 SIC Code:8621 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title LORI KEITH / / Business Phone: (661) 324-3783x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone, ( ) - x Pager Phone ( ) - x Hazmat Hazards: React f Contact Phone: (661) 324-3783x MailAddr: 1711 30TH ST State: CA City BAKERSFIELD Zip 93301 Owner MICHAEL A BANDUCCI DDS Phone: (661) 324-3783x Address 1711 30TH ST 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 ~~~ Based on my inquiry of those individuals responsible for obtaining the information, I certify ~/ , n \ under penalty of law that I have personally -V\~ examined and am famili with the information submitted and lieve a in ormation is true, CC accur a~ co ple . ~/~ ~"©~ Signature Date ENT°p ,~~IN Q 2 zoos -1- 05/10/2006 f ~` i BANDUCCI DDS MICHAEL A ~ SiteID: 015-021-002335 Manager ~. j (~~~ ~~ ~~-I~ Bus Phone : ( 6 61) 3 2 4 - 3 7 8 3 Location: 1711 30TH ST ~ Map 102 CommHaz Minimal City BAKERSFIELD Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:8621 DunnBrad: Emergency Contact / Title /~ Emergency Contact / Title LORI KEITH / ~~~~(~ ~ ~, / Business Phone: (661) 3 4-3783x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x ................ Hazmat Hazards: React -_ .......... Contact : ~(~. ~-(C~`e~ ~,,~~~,~ Phone: (661) 324-3783x MailAddr: 1711 30TH ST State: CA City BAKERSFIELD Zip. 93301 ............. Owner MICHAEL A BANDUCCI DDS Phone: (661) 324-3783x Address 1711 30TH ST State: CA City BAKERSFIELD Zip 93301 ............ Period to TotalASTs: = E~al Preparers TotalUSTs: = Coal Certif'd: RSs: No ParcelNo: ............... Emergency Directives: PROG H - HAZ WASTE GEN ~ ~~ `~~D ~ ~ ~ ~ ~ ~~~~ Based on my inquiry of those individuals responsible for obtaini the information, I certify _ under penalty of I r hat I have personally examined and a ifiar with the information submitted an ie the information is true, acc~ , an c pl~e e. - `` ~ Zl~ G . Signat re --' Date -1- O1/26/~b07 F BANDUCCI DDS MICHAEL A ~ Hazmat Inventory ~ MCP+DailyMax Order = = SiteID: 015-021-00233 ~' By Facility Unit ~ Fixed Containers at Sites ~ ............... Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit 1~ICP WASTE FIXER R L 2.00 GAL Ntn -2- O1/26/Zb07. -3- Ol/26/~b07 ,, F BANDUCCI DDS MICHAEL A SiteID: 015-021-002335 ~ ~ 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 TWasteAmbient ~ Ambient I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 2.00 GAL 2._0.0 GAL Daily Average 2.00 GAL I1HGL-iRLVIJJ l.Vl°lYV1V L'1V 1.7 %Wt. RS CAS# Silver No 7440224 -- I1HGFiItL tiJ JL~.7 J1~1P~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCA No No No No/ Curies R / / / Mi -4- Ol/26/2~07 ~ F BANDUCCI DDS MICHAEL A SiteID: 015-021-00235 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Sits ~ r~y~llc:y 1v~Lizicazion _ ~ r / ~, l~ui~ivy cc LVV I..ll ~ r+Vdlr Udl. 1.V11 t UiJ11C: 1VV t~11 ~ L' VdC:Udl.1Ui1 l L~lllClyCllC:y 1°1CU1C:d1 Y1dI1 -5- 01/26/2607 i' F BANDUCCI DDS MICHAEL A SiteID: 015-021-002335 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Sits ~ ~ Release Prevention Release Containment 1..1Cd11 UtJ Other Resource Activation -6- Ol/26/2d07 ~. F BANDUCCI DDS MICHAEL A SiteID: 015-021-002335 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ oNc~:idi nac~diu~ u~iii~y ~iiu~-emirs ,_ t'11C rl.VLCI~~tiVd11 V4dl.Cl aLL11U1i1y vc:c:uYcincy Level -7- O1/26/~b07 !_, - ~~ F BANDUCCI DDS MICHAEL A SiteID: 015-021-002335 ~ Fast Forme ~ ~ Training Overall Sites ~ ~ Employee Training rayc c c Held for Future Use nciu iv.L ru~.ui.c vac -8- Ol/26/~b07 '~~ ~ ` '~ ~* Prevention Services -UNIF1~~ PROGRAM INSPECTION CHECKLIST ~ j`. __ R A r a s >: , D 9001Yt.1xtun Ave., Suite 210 - tFeAF Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program '°R'M Tei.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ - ~ 3 , INSP C ION D TE ~ INSPECTION TIME I N„~,t~ ~~s ~ a ADDRESS ^ 1 ~ ~„~ L ~ PHO~ ND. ~~ ~~ , ! O OF EM~OYEES ~ ~ S '4 1 E [ - FACILITY CONTACT ~ S ID NUMBER BUSIN S 15-021- 01S ^ oz ~ _c~o Section 1: Business Plan and Inventory .Program ^ ROUTINE~COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION Y I 33q C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~ ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION T'D qP 2 ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ~Ll ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ~~ ~ FIRE PROTECTION • j, ~ S V ~ C..Q.~ ti ~C._ (r Sit T ~ K +.~. ~~u: ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON S(~ITE? CI.7YES ^ NO EXPLAIN: ~ ~~~- "~i ?k e' r QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 i /~ `-~r-~ m Inspector (Please Print) Fire Prevention / 1~' In /Shift of Site/Station # Business Site /Responsible Party (Plea a Print). White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ~04~`- -'~~'`~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~~ ~~ OFFICE OF ENVIRONMENTAL SERVICES ~' .y UNIFIED PROGRAM INSPECTION CHECKLIST ;~~~~~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME~~ 3~~'~ G~- ~ INSPECTION DATE ~-f''1 ~~ (° Section 4: Hazardous Waste Generator Program EPA ID # [oJ~ ~ "-~ ^ Routine ~i Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~' X ~ :~. ~-~" Authorized for waste treatment and/or storage Reported release, fire, or explosion within I S 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 N Secondary containment provided Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste N Proper management of lead acid batteries including labels d~ ~ Proper management of used oil filters ~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC a ~~ Retains manifests for 3 years 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: ~ ~G ~(G' y' 1 Office of Environmental Services (661) 326-3979 White -Env. Svcs. .~ ~~ r ~~ siness Site Respo Bible Party Pink -Business Copy {~ ~v ~:. BANDUCCI DDS MICHAEL A Manager MICHAEL BANDUCCI Location: 1711 30TH ST City BAKERSFIELD SiteID: 015-021-002339 BusPhone: (661) 324-3783 Map 102 CommHaz Minimal Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: SIC Code:8621 DunnBrad: Emergency Contact / Title Emergency Contact '/ Title LORI KEITH / DENTAL ASST / Business Phone: (6670 324-3783x Business Phone: (~~) ~/ ~~"~~l. x 2 4 -Hour Phone ((!j~ f ) ~~' ( - ~~x 2 4 -Hour Phone (~ ( ) ~~cj =7~'j ~ x Pager Phone ( )_ - x Pager Phone ( ) - x Hazmat Hazards: ~ React Contact MICHAEL BANDUCCI Phone: (661) 324-3783x MailAddr: 1711 30TH ST State: CA City BAKERSFIELD Zip 93301 Owner MICHAEL A BANDUCCI DDS Phone: (661) 324-3783x Address 1711 30TH ST 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 ~~~°~ ~ c T ~ z~a~ f'.r~f:d on my inquiry of those individual, respon aik~ie for obtaining the information, f c.=rtify under penalty of law that 1 have personally Qxamined and am far~°~liar h the information submitted and bel' v t nformation is true, accurate, o le e. j r `~~~ ~~ Signature Date -1- 10/01/2007 T ~ BANDUCCI DDS MICHAEL A SiteID: 015-021-002339 ~ ~ 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 2.00 GAL Min -2- 10/01/2007 -3- to/ol/aoo~ F BANDUCCI DDS MICHAEL A ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit DARKROOM SiteID: 015-021-002339 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# Liquid TWaste ~-AmbRent~E ~ AmbientT~E ~ PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 2.00 GAL 2.00 GAL 2.00 GAL tit',Gf1tt11VUJ w1~lrVlv~lvlJ oWt. RS CAS# Silver No 7440224 t1HGHKJJ H.S ~~~JL~1L"1V1~ TSecret RS BioHaz RadioactivejAmount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 10/01/2007 r F BANDUCCI DDS MICHAEL A SiteID: 015-021-002339 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/26/2007 ~ CALL 911 Employee Notif./Evacuation 04/26/2007 VERBAL NOTIFICATION AND EXIT THROUGH FRONT DOOR AND EMERGENCY EXIT. Public Notif./Evacuation 04/26/2007 VERBAL NOTIFICATION AND EXIT THROUGH FRONT DOOR OR EMERGENCY EXIT. Emergency Medical Plan 04/26/2007 TRANSPORT TO HOSPITAL BY AMBULANCE. -5- 10/01/2007 P BANDUCCI DDS MICHAEL A SiteID: 015-021-002339 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/26/2007 ~ SECONDARY CONTAINMENT Release Containment 04/26/2007. SECONDARY CONTAINMENT Clean Up 04/26/2007 MOP UP WITH TOWELS OR ABSORBANT. Other Resource Activation -6- 10/01/2007 F BANDUCCI DDS MICHAEL A SiteID: 015-021-002339 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ arc~:icti nac.ctiu~ Utility Shut-Offs 04/26/2007 GAS: S SIDE OF BLDG ELECTRICAL: S SIDE OF BLDG WATER: S SIDE OF BLDG Fire Protec./Avail. Water FIRE EXTINGUISHER FIRE HYDRANT: H ST & ALLEY 04/26/2007 Building Occupancy Level 04/26/2007 8 EMPLOYEES -7- 10/01/2007 .. F BANDUCCI DDS MICHAEL A SiteID: 015-021-002339 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 04/26/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: OSHA IN-HOUSE TRAINING cayc c. .7 ~ L. •aciu ivy. i-u~uic vac nC1U tvt rUI.UtC VwSC -8- 10/01/2007