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HomeMy WebLinkAboutBUSINESS PLAN ~~ ~ ~~j ~~~ ~,~' ~ ~~ i ~_: I ~ ~ , ;~ C.~ ,~ ~ .Y B BKFLD VETINARY HOSP. 323 CHESTER AVENUE _ _ _ -:';~ Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST ~~`'.~__ -~' B a_ F R s ~ , . „ 900 Truxtun Ave., Suite 210 FIRE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ~ r"' Tel.: (661) 326-3979 .,~.. • - ~ 4'~~''" ^~'' Fax: (661) 872-2171. -- -_ ~ _ __ __ _ _ - - nn - Section 1: Business Plan and Inventory Program t/ ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION. FACIL~~122TY NAME ,u e ~ 1~ l~L'C' oS~ INSPECTION DATE mil-/S~dC~ NSPECTION TIME O ; Ho ADDRESS PHONE NO. NO OF EMPLOYEES FACILITY CONTACT - BUSINESS ID NUMBER 15-021- C~QO 7`~ .D 2 vti c- G2v~.~ C V r C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~tl ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE U P b~'g~ ~Kar~- ~ ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL C ` \ - `~U ^ VERIFICATION OF MSDS AVAILABILITY s~ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION +.Jee.J Tt~ Ct-(r~-+ S oYte- v~ ieGT'ca2.. /*,' ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ~'e-6~^'~ `~`~~ `^~~e~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy ®'YES ^ NO~~ FD 2155 (Rev. 09/05 ;, "~ BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-00071 Manager VANESSA LOPEZ Location: 323 CHESTER AVE City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: BusPhone: (661) 327-4444 " Map 103 CommHaz Low Grid: 31C FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title DR MCGRAW / OWNER / Business Phone: (6.61) 327-4446x Business Phone: (661) 327-4444x 24-Hour Phone (661) 808-7739x 24-Hour Phone (661) ~'-~-2~ Pager Phone (661) 333-9537x Pager Phone ( ) - x _.... Hazmat Hazards: Fire Press React ImmHlth ....... Contact DR MCGRAW Phone: (661) 327-4444x MailAddr: 323 CHESTER AVE State: CA City BAKERSFIELD Zip 93301 ............... Owner BAKERSFIELD VETERINARY HOSP TAL Phone: (661) 327-4444x Address 323 CHESTER AVE State: CA City BAKERSFIELD Zip 93301 ............... Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT v~s~~. ~P~ Z ~-~'~~ ' eC~th,( Gl' PROG H - HAZ WASTE GEN V t~n1~. ~~G7UL~ ~~ ~ ` ~ ~ ~J~ ~~ ~d~' lP~-I~ 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, ~~ accurate, and complete. IY ~ FF ~ ~ ~ ~ 2 2 2~ OT igna re Date -1- 0l/26/007 F BAKERSFIELD VETERINARY HOSPITAL SitelD: 015-021-00071 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MAP OXYGEN WASTE FIXER F P IH G R L 1697.00 5.00 FT3 GAL Low din =2- O1/26/~007 -3- O1/26/~007 ~` i F~BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: S WALL LAUNDRY RM/SURGERY RM SE CRNR 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 1697.00 FT3 1697.00 FT3 1697.00 FT3 HA6AllJJUUS CUMPUNENTS oWt. RS CAS# 100.00 Oxygen, Compressed No 7782447 tltiatittU 1-~Aa~aJl~l~ly 1,' TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit INSIDE X-RAY DARKROOM Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: -- CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste ~ Ambient ~ Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAt~ ruaunicLV~~ ~.vi•lrvlvr~lvlw7 %Wt• RS CAS# Silver No 744024 ilf']LJriCCL 1"1 7 ~7 P~J.71.1Li1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCA No No No No/ Curies R / / / M~1 -4- 01/26/2007 F BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ Fast Format ~ ~-Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 03/26/1999 ~ FIRE DEPT - CALL 911. Employee Notif./Evacuation 04/14/20176 WORD-OF-MOUTH. OUR FACILITY IS NOT LARGE ENOUGH TO REQUIRE BELLS OR ALARMS. Public Notif./Evacuation 12/05/1996 WE DO NOT NOTIFY THE PUBLIC. ONE EMPLOYEE IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION OF OTHERS IS NECESSARY. Emergency Medical Plan 04/14/2006 MERCY HOSPITAL, 2215 TRUXTUN AVE, 632-5275; DR AJITPAL TIWANA MD, 2635 G S'~`, 325-5513. -5- O1/26/~007 F BAKERSFTELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/29/1990 ~ CYLINDERS PROPERLY CHAINED, PROPER VALVES & FITTINGS. Release Containment 04/14/2006 WE STORE ONLY OXYGEN. IF RELEASE IN A CONFINED SPACE, WE AERATE THE BUILDING TO PREVENT HAZARD TO ITS OCCUPANTS.' Clean Up NO SPECIAL MATERIALS OR EQUIPMENT IS NECESSARY FOR OXYGEN. 12/23/20175 Other Resource Activation -6- 01/26/2007 F BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-00074]. ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ Special Hazards 01/26/20177 BIG DOGS REAR OF COMPOUND. Utility Shut-Offs 01/26/2007 A) GAS - S SIDE BLDG 6FT W OF CTR DOOR B) ELECTRICAL - N SIDE OF BLDG E CRNR CARPORT C) WATER - W SIDE BLDG S FLOWER BED D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 04/14/2006 PRIVATE FIRE PROTECTION - WE HAVE ABC-TYPE FIRE EXTINGUISHERS FOR USE BY OUR EMPLOYEES IN FIGHTING FIRE IF IT IS SAFE TO DO SO. FIRE HYDRANT - WE ARE BETWEEN TWO FIRE HYDRANTS - BOTH OF WHICH ARE APPROX 325 FT FROM THE BLDG. 1 ON NW CRNR OF THIRD & CHESTER; 1 ON SW CRNR INTERSECTION FOURTH & CHESTER. Building Occupancy Level 04/14/20b6 15 EMPLOYEES -7- 01/26/2007 ~~ F BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training Ol/26/20C17 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WRITTEN INSTRUCTION. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, EVACUATION, ETC. POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. rage ~ nciu ivL ru~.uic ~~c n~iu iui ruuure use -8- O1/26/Z007 BAKERSFIELD VETERINARY HOSPITAL Manager VANESSA LOPEZ Location: 323 CHESTER AVE City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: BusPhone: Map 103 Grid: 31C SIC Code: DunnBrad: SiteID: 015-021-000741 (661) 327-4444 CommHaz Low FacUnits: 1 AOV: Emergency Contact / Title Emergency Contact / Title DR MCGRAW / OWNER VANESSA LOPEZ / HEAD TECHNICIAN Business Phone: (661) 327-4446x Business Phone: (661) 327-4444x 24-Hour Phone (661) 808-7739x 24-Hour Phone (661) 873-1159x Pager Phone (661) 333-9537x Pager Phone (661) 303-6344x Hazmat Hazards: Fire Press React ImmHlth Contact DR MCGRAW Phone: (661) 327-4444x MailAddr: 323 CHESTER AVE State: CA City BAKERSFIELD Zip 93301 Owner BAKERSFIELD VETERINARY HOSPITAL Phone: (661) 327-4444x Address 323 CHESTER AVE State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ~~r~ J~ ~ ~ ~ ~~al 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, accurate, and complete. Sign lure Da e -1- ~ 06/29/2007 F BAKERSFIELD VETERINARY HOSPITAL SitelD: 015-021-000741 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN F P IH G 1697.00 FT3 Low WASTE FIXER R L 5.00 GAL Min -2- 06/29/2007 -3- 06/29/2007 F BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME OXYGEN. Days On Site 365 Location within this Facility Unit Map: Grid: S WALL LAUNDRY RM/SURGERY RM SE CRNR CAS# 7782-44-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas TPure -Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest C1697100rFT3 Daily1697100m FT3 I Daily1697r00e FT3 nrac,rutLV~J ~.vl-1rv1v1J1.v1S %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 ru-~c~s~cL r~J a~aJilr~lvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE X-RAY DARKROOM CAS# Liquid TWaste ~ Ambient~E ~ AmbientT~E ~PLASTICTCONTAINERE _ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL HA ZARDOUS COMPONENTS %Wt. RS CAS# Silver No 7440224 rltiGtitCL H J~JI;JJ1~11;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 06/29/2007 F BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 03/26/1999 ~ FIRE DEPT - CALL 911. Employee Notif./Evacuation 04/14/2006 WORD-OF-MOUTH. OUR FACILITY IS NOT LARGE ENOUGH TO REQUIRE BELLS OR ALARMS. Public Notif./Evacuation 12/05/1996 WE DO NOT NOTIFY THE PUBLIC. ONE EMPLOYEE IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION OF OTHERS IS NECESSARY. Emergency Medical Plan 04/14/2006 MERCY HOSPITAL, 2215 TRUXTUN AVE, 632-5275; DR AJITPAL TIWANA MD, 2635 G ST, 325-5513. -5- 06/29/2007 F BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/29/1990 ~ CYLINDERS PROPERLY CHAINED, PROPER VALVES & FITTINGS. Release Containment 04/14/2006 WE STORE ONLY OXYGEN. IF RELEASE IN A CONFINED SPACE, WE AERATE THE BUILDING TO PREVENT HAZARD TO ITS OCCUPANTS. Clean Up 12/23/2005 NO SPECIAL MATERIALS OR EQUIPMENT IS NECESSARY FOR OXYGEN. V1.11CL lCCWILLC~C L'iC:l~lVdl,lU11 -6- 06/29/2007 F HAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards 01/26/2007 ~ BIG DOGS REAR OF COMPOUND. Utility Shut-Offs 01/26/2007 A) GAS - S SIDE BLDG 6FT W OF CTR DOOR B) ELECTRICAL - N SIDE OF BLDG E CRNR CARPORT C) WATER - W SIDE BLDG S FLOWER BED D) SPECIAL - NONE ' E) LOCK BOX - NO Fire Protec./Avail. Water 04/14/2006 PRIVATE FIRE PROTECTION - WE HAVE ABC-TYPE FIRE EXTINGUISHERS FOR USE BY OUR EMPLOYEES IN FIGHTING FIRE IF IT IS SAFE TO DO SO. FIRE HYDRANT - WE ARE BETWEEN TWO FIRE HYDRANTS - BOTH OF WHICH ARE APPROX 325 FT FROM THE BLDG. 1 ON NW CRNR OF THIRD & CHESTER; 1 ON SW CRNR INTERSECTION FOURTH & CHESTER. Building Occupancy Level 15 EMPLOYEES 04/14/2006 -7- 06/29/2007 F BAKERSFIELD VETERINARY HOSPITAL SiteID: 015-021-000741 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/26/2007 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WRITTEN INSTRUCTION.. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, EVACUATION, ETC. POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. rayc ~ nclu tVL rUI.ULC V.~'C nciu tVi ruI.UIC VSC -8- 06/29/2007 ~' f. + BAKERSFIELD VETERINARY HOSPITAL _____________________ SiteID: 015-021-000741 + Manager DR MCGRAW Location: 323 CHESTER AVE City BAKERSFIELD BusPhone: (661) 327-4444 Map 103 CommHaz Low Grid: 31C FacUnits: 1 AOV: CommCode: BFD STA 06 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title DR MCGRAW / OWNER LAURIE A BEAVER / Business Phone: (661) 327-4446x Business Phone: (661) 327-4444x 24-Hour Phone (661) ~-~' ~24-Hour Phone (661) 633-2232x Pager Phone (661) 333-9537x Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth Contact DR MCGRAW Phone: (661) 327-4444x MailAddr: 323 CHESTER AVE State: CA City BAKERSFIELD Zip 93301 Owner BAKERSFIELD VETERINARY HOSPITAL Phone: (661) 327-4444x Address 323 CHESTER AVE State: CA City BAKERSFIELD Zip 93301 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 certify under penalty of iaw that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~~~.~ Sign ture Dat END A~~ .14 ?~~6 t______________________________________________________________________________+ -1- 03/08/2006 `V~y,~,. ~~'~ CITY OF BAKERSFIEI.D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES ~' •'~ UNIFIED PROGRAM INSPECTION CHECKLIST ~w ~R~/art 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 6 ~pp3 ~G~ FACILITY NAME L~q~F~s-+Ir~r~ Ue ~ ~as~ fNSPECTION DATEGJ- Zz-O 3 ADDRESS 2 C ~P ~~ J''~ PHONE NO. 3 27 ~ ys/~/~~ FACILITY CONTACT .e2 BUSINESS ID NO. 15-21U- 0607// INSPECTION TIME NLIMBER OF EMPLOYEES /,~' Section 1: Business Plan and Inventory Program Routine ^ Combined ^ 3oint Agency ^MuIti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate N ~l,~J``:= ~" - Visible address r- ,~,~,~;;:- %~ Correct occupancy .~ Verification of inventory materials Verification of quantities ,Q Verification of location ~( Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ^ Yes ~ No Explain: Questions regarding this inspection2 Please call us at (661) 326-3979 White -Env. Svcs. Yellow -Station Copy Pink -Business Copy ~~~l~~r yl ,~ "~~'" . .~? C ' rJ ^~~. + BAKERSFIELD VETERINARY HOSPITAL _____________________ SiteID: 015-021-000741 + Manager DR. MCGRAW BusPhone: (661) 327-4444 Location: 323 CHESTER AVE Map 103 CommHaz Low City BAKERSFIELD Grid: 31C FacUnits: 1 AOV: CommCode: BFD STA 06 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title DR. MCGRAW / OWNER LAURIE A BEAVER / Business Phone: (661) 32T-4446x Business Phone: (661) 327-4444x 24-Hour Phone (661) 873-0904x 24-Hour Phone (661) 633-2232x Pager Phone (661) 333-9537x Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth Contact DR. MCGRAW Phone: (661) 327-4444x MailAddr: 323 CHESTER. AVE State: CA City BAKERSFIELD Zip 93301 Owner BAKERSFIELD VETERINARY HOSPITAL Phone: (661) 327-4444x Address 323 CHESTER AVE State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: Based on my inquiry of those individu;s.ls responsible for obtaining the information, 1 certify under penalty of law that 1 have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ig ture Date -1- 12/14/2005 + BAKERSFIELD VETERINARY HOSPITAL _____________________ SiteID: 015-021-000741 + += Hazmat Inventory _________________________________________ By Facility Unit + +_= MCP+DailyMax Order ______________________________ Fixed Containers on Site + Hazmat Common Name... ~SpecHaz~EPA Hazards Frm ~ DailyMax ~Unit~MCP~ OXYGEN F P IH G 1697.00 FT3 Lowl WASTE FIXER R L 5.00 GAL Min -2- 12/14/2005 -3- 12/14/2005 + BAKERSFIELD VETERINARY Hd~SPITAL _____________________ SiteID: 015-021-000741 + += Inventory Item 0001 _______________ Facility Unit: Fixed Containers on Site + +_= COMMON NAME / CHEMICAL NAME ______________________________+________________+ OXYGEN Days On Site I 365 I Location within this Facility Unit Map: Grid: +----------------+ S WALL OF LAUNDRY RM/SURGL~`'RY RM SE CORNER I CAS# I 7782-44-7 += STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+ Gas ~ Pure ~ Above Ambient ~ Ambient ~ PORT. PRESS. CYLINDER +__________________________+ AMOUNTS AT THIS LOCATION =________________________+ Largest C1697100rFT3 I Daily1697100m FT3 I Daily1697r00e FT3 I +_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+ 1100t00lOxygen, Compressed) INoSI CAS#77824471 +_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+ ITSNcoretlNRoSIBNooHazl RNod~oactive/Cu~ies ~ FPP HalHrds I %F~A/ I USDOT# I Low I += Inventory Item 0003 _______________ Facility Unit: Fixed Containers on Site + +_= COMMON NAME / CHEMICAL NAME ______________________________+________________+ WASTE FIXER Days On Site SPENT PHOTOGRAPHIC FIXER I 365 Location within this Facility Unit Map: Grid: +----------------+ INSIDE X-RAY DARK ROOM ~ CAS# ~ += STATE _+= TYPE ___+_= PREISSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+ Liquid. ~ Waste ~ Ambu.ent ~ Ambient I PLASTIC CONTAINER +__________________________+ AMOUNTS AT THIS LOCATION =________________________+ I Largest Container ~ Daily Maximum I Daily Average I 5.00 GAL 5.00 GAL 5.00 GAL +_______I+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+ I %Wt. ISilver INoSI CAS#74402241 +_______+___+______+_______=__= HAZARD ASSESSMENTS =__+_________+________+_____+ ITSNcoretlNoSlBNooHazl RNod~oactive/Curies I EPA HRazards I jF~A/ I USDOT# I Min I -4- 12/14/2005 + BAKERSFIELD VETERINARY HOSPITAL =____________________ SitelD: 015-021-000741 + +_________________________________________________________________ Fast Format + += Notif./Evacuation/Medical ____________________________________ Overall Site + +_= Agency Notification ___________________________________________ 03/26/1999 + FIRE DEFT - CALL 911. +__= Employee Notif./Evacuation ___________________________________ 10/29/1990 + WORD OF MOUTH. OUR FACILITY IS NOT LARGE ENOUGH TO REQUIRE BELLS OR ALARMS. +___= Public Notif./Evacuation ____________________________________ 12/05/1996 + WE DO NOT NOTIFY THE PUBLIC. ONE EMPLOYEE IS DESIGNATED TO ASK THE SENIOR FIREMAN PRESENT IF NOTIFICATION OF OTHERS IS NECESSARY. +____= Emergency Medical Plan _____________________________________ 08/19/2003 + MERCY HOSPITAL - 2215 TRUXTUN AVE - 632-5275 DR. AJITPAL TIWANA, M.D. - 2635 G STREET - 325-5513 -5- 12/14/2005 + BAKERSFIELD VETERINARY HC~~SPITAL _____________________ SiteID: 015-021-000741 + +_________________________________________________________________ Fast Format + += Mitigation/Prevent/Abatem~t ___________________________________ Overall Site + +_= Release Prevention ____________________________________________ 10/29/1990 + CYLINDERS PROPERLY CHAINED', PROPER VALVES & FITTINGS. +__= Release Containment __________________________________________ 10/29/1990 + WE STORE ONLY OXYGEN "''~_-*~-'" IF RELEASE IN A CONFINED SPACE, WE AREATE THE BUILDING TO PREVENT HAZARD TO ITS OCCUPANTS. +___= Clean Up ____________________________________________________ 10/29/1990 + dV~ NO SPECIAL MATERIALS OR EQUIPMENT IS NECESSARY FOR OXYGEN A~~~~~. +____= Other Resource Activation ______________________________________________+ ----- ------------------------------------------------------- -6- 12/14/2005 + BAKERSFIELD VETERINARY HOSPITAL _____________________ SiteID: 015-021-000741 + +_________________________________________________________________ Fast Format + += Site Emergency Factors _______________________________________ Overall Site + +_= Special Hazards _______________________________________________ 03/26/1999 + BIG MEAN DOGS IN REAR OF COMPOUND. +__= Utility Shut-Offs ____________________________________________ 03/26/1999 + A) GAS - S SIDE BLDG, 6 FT W OF CENTER DOOR B) ELECTRICAL - N SIDE OF'BLDG ON E CORNER OF CAR PORT C) WATER - W SIDE OF BLDG IN S FLOWER BED D) SPECIAL - NONE E) LOCK BOX - NO +___= Fire Protec./Avail. Water ___________________________________ 03/26/1999 + PRIVATE FIRE PROTECTION - WE HAVE ABC TYPE FIRE EXTINGUISHERS FOR USE BY OUR EMPLOYEES IN FIGHTING FIREI IF IT IS SAFE TO DO SO. FIRE HYDRANT - WE ARE BETWEEN TWO FIRE HYDRANTS - BOTH OF WHICH ARE APPROXIMATELY 325 FT FROM THE BLDG. 1 ON THE NW CORNER OF THIRD AND CHESTER; 1 ON THE SW CORIWIIER OF INTERSECTION OF FOURTH AND CHESTER. t______________________________________________________________________________+ +____= Building Occupancy L~evel _______________________________________________+ -7- 12/14/2005 ~, ~. + BAKERSFIELD VETERINARY HOSPITAL _____________________ SiteID: 015-021-000741 + +_________________________________________________________________ Fast Format + += Training _____________________________________________________ Overall Site + +_= Employee Training _____________________________________________ 03/26/1999 + WE HAVE 15 EMPLOYEES AT THIS FACILITY (NEVER ALL HERE AT THE SAME TIME). WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING:: WRITTEN INSTRUCTION. ORIENTATION ON LOCATION OF EXTINGUISHERS, CYLINDERS, EVACUATION ROUTES, EVACUATION, ETC. POSTED FIRE PLANS AND HAZARDOUS MATERIALS INFORMATION. +--- Page 2 ___________________________________________________________________+ *______________________________________________________________________________t +___= Held for Future Use =____________________________________________________+ t______________________________________________________________________________+ +____= Held for Future Use ____________________________________________________+ ------- ------------ -------------------- ---------------------- -8- 12/14/2005 UNIFIED PROGRAM INSPECTION CHECKLIST Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661)_326-3979 _ _ _ SECTION 1 Business .Plan and Inventory Program FACILITY NAME WSPECTION DATE INSPECTION TIME ADDRESS PHONE No. No. of Employ FACILITYCONTACT 8uainess ID Number 15-021-~8 7~/ Section 1: Business Plan and Inventory Program tine ^ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V (v=vio~u ~n~e~ OPERATION COMMENTS I~ ^ APPROPRIATE PERMIT ON HAND ,. ~/ ^ L7 BUSINESS PLAN CONTACT INFORMATION ACCURATE ~~'~ ~j 3~ u~ ~~,(tjJ i~ ^ VISIBLE ADDRESS l~ ^ CORRECT OCCUPANCY ^ Lfi VERIFICATION OF INVENTORY MATERIALS ~ .n s? /,f,1©~~ ~,/,/~~~ A/~~~ ~/~ i~ /'G LPL / ~7 ~~ <!~ VERIFICATION OF QUANTITIES --- ---- - -_-------___.. __ _..._...._...._._.. ._.__...:. _....____.. ----....- .I ----.. ... _~_ _ __.-- .. ~ ^ .VERIFICATION OF LOCATION J- - L7 ^ ----- - ---- ~ - --- PROPER SEGREGATION OF MATERIAL -... - - -. ._._. .. _..... .. _ _..._.__ ....... _ --_..... ^ VERIFICATION OF MSDS AVAILABILITYE fJ ^ VERIFICATION OF HAT MAT TRAINING ~^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES _.. _..-- r L~ ^ EMERGENCY PROCEDURES ADEQUATE ...._......._ ----.._ -- --- ... _... _...._ .... I Q ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING _. C3 ^. FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE?: LJ'TES ^ NO EXPLAIN: _ St~.~ G GIJ~/1~/~ ~~~~/~ QUESTIONS RE RDING THIS INSPECTION? PLEASE uS AT (661) 326-3979 ~ ~ ~ -_ ..__ICl'_,~ ----~-- Inspector (Please Print) . .__._ .._ _ ..._ -----. _ ..- --`------ Fire Prevention 1 tg In/Shift of Site 'nt~Site Re~arty (Please Print) B „'--- `~ While -Environmental Services Yelknv • Station Copy Pink - 8usinesa Cop " _\