The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN 7/13/2007COLUMBUS FAMILY DENTISTRY __ _ _ _ _ 505 W. COLUMBUS STREET r y COLUMBUS FAMILY DENTISTRY Manager AURORA DELEON Location: 505 W COLUMBUS ST City BAKERSFIELD CommCode: BFD STA 04 EPA Numb: SiteID: 015-021-002061 BusPhone: (661) 322-1300 Map 103 CommHaz Minimal Grid: 19B FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title MIKE SAGARIAN / OWNER AURORA DELEON / MANAGER Business Phone: (661) 322-1300x Business Phone: (661) 322-1300x 24-Hour Phone (661) 665-2378x 24-Hour Phone (661) 871-8796x Pager Phone (661) 496-1200x Pager Phone (661) 319-4163x Hazmat Hazards: React Contact MIKE SAGARIAN Phone: (661) 322-1300x MailAddr: 505 W COLUMBUS ST State: CA City BAKERSFIELD Zip 93301 Owner COLUMBUS FAMILY DENTISTRY Phone: (661) 322-1300x Address 505 W COLUMBUS 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 ENT'D J U L 1 6 ~QQ7 d a~_~~ on my inquiry of those individuals resonn€;ib1e for obtaining the information, I certify u:;;der per"+aity or !aw that 1 have personally examined and am familiar with the information sui~~mitted a.nr_? t;eiieve the information is true, accurate, and complete. ~ ~~ C.7~ Signat~, e Date -1- 07/10/2007 r F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002061 ~ ~ 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 10.00 GAL Min -2- 07/10/200,7 ~. -3- 07/10/2007 F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002061 ~ ~ 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: STERILIZATION LAB 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 10.00 GAL 10.00 GAL tlr~~r~tclJVU~ ~ulnrvlv~lv~l~~ __ _ Silver No 7440224 ti1~GL-1ttiJ A7 ~L' 7 71~11"~1V 1 7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/10/2007 F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002061 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/30/2000 ~ DAILY VISUAL MONITORING. Employee Notif./Evacuation 10/30/2000 - - -VERBAL NOTIFICATION . ^ - --i _ r~ - _ -- _ ~ _,_ Public Notif./Evacuation OFFICE MANAGER RESPONSIBLE FOR WASTE HANDLING. 10/30/2000 Emergency Medical Plan 10/30/2000 CLOSEST HOSPITAL, MEMORIAL. -5- 07/10/2007 F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002061 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/30/2000 ~ REGULAR SERVICE. = Release Containment 10/30/2000 SECONDARY CONTAINMENT. - - - _~~_ _ _ ~_ _~__--_- -----~--- - - =----- ----- -_-~__--- - - -- - - --~ _ - Clean Up 07/24/2006 WASTE REMOVED WHEN CONTAINER IS NEARLY FULL. V~.11Gt [~C r7VUL l.:C 1'il: l.lVdl.1 V11 -6- 07/10/2007 F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002061 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~.IGV 1C,t1 nac~aiu~ = Utility Shut-Offs WATER - NEAR SIDE EXIT = 03/02/2007 Fire Protec./Avail. Water 05/08/2006 PRIVATE FIRE PROTECTION - SPRINKLERS. Building Occupancy Level 05/08/2006 8 EMPLOYEES -7- 07/10/2007 ,, P COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002061 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 07/24/2006 ~ NO MSDS SHEETS ON FILE - WASTE PRODUCT ONLY. BRIEF SUMMARY OF TRAINING PROGRAM: ROUTINE OPERATION OF X-RAY DEVELOPER. Page 2 Held for Future Use raciu ivi ru~uic vac -8- 07/10/2007 t~ ~1 1 ~, COLUMBUS FAMILY DENTISTRY BusPhone: Map 103 Grid: 19B SiteID: 015-021-002061 Manager AURORA DELEON Location: 505 W COLUMBUS ST City BAKERSFIELD CommCode: BFD STA 04 EPA Numb: SIC Code: DunnBrad: (661) 322-1300 CommHaz Minimal FacUnits: 1 AOV: Emergency Contact / Title Emergency Contact / Title M SAGHARIA / OWNER AURORA DELEON / MANAGER Business Phone: (661) 322-1300x Business Phone: (661) 322-1300x 24-Hour Phone (661) 665-2378x 24-Hour Phone (661) 871-8796x Pager Phone ( ) - x Pager Phone (661) 835-3872x Hazmat Hazards: React ~__._ . _ ....... Contact {~~rr~>~,. Sr "1.~~~Ge.~/`- ~ Phone: (661) 322-1300x MailAddr: 505 W COLUM S ST State: CA City BAKERSFIELD Zip 93301 ............. Owner COLUMBUS FAMILY DENTISTRY Phone: (661) 322-1300x Address 505 W COLUMBUS 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 ENT ~' ~ ~ ~ 3 ~~~7 Based on my inquiry of_ those individuals nsible for obtaining the information, I certify respo 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. - nf r~~ to~ rr Signatur Date -1- Ol/29/~007 a' F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002061 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit N~CP WASTE FIXER R L 10.00 GAL 1~in -2- O1/29/~b07 t -3- O1/29/~007 F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-00201 ~ ~ 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: STERILIZATION LAB CAS# STATE TYPE Liquid Waste = PRESSURE Ambient Largest Container 5.00 GAL TEMPERATURE _ Ambient AMOUNTS AT THIS LOCATION Daily Maximum 10.00 GAL Daily Average 10.00 GAL iltiGriRLVUJ COMPONENTS %Wt. - ~ RS CAS# - - Silver No 7440224 Ilt~[~riRL H JJP~J J1.11;1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCA No No No No/ Curies R / / / Min CONTAINER TYPE PLASTIC CONTAINER -4- Ol/29/2~07 F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002061 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Sites ~ ~ Agency Notification 10/30/2000 ~ DAILY VISUAL MONITORING. Employee Notif./Evacuation 10/30/2000 VERBAL NOTIFICATION. - _ -- _ -~ _ Public Notif./Evacuation 10/30/2000 OFFICE MANAGER RESPONSIBLE FOR WASTE HANDLING. ~- Emergency Medical Plan 10/30/2000 CLOSEST HOSPITAL, MEMORIAL. -5- .01/29/2007 F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002061 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention _10/30/20010 ~ REGULAR SERVICE. = Release Containment 10/30/2000 SECONDARY CONTAINMENT. - - -~ - -- -- -'-=-- °-- -. -~-_,~ .. .,- _ _ _ -_ ; Clean Up 07/24/20(76 WASTE REMOVED WHEN CONTAINER IS NEARLY FULL. VI.11CL 1CC.7"V ILL (.:C L'iC: l..1Vdl~1C.JI1. -6- 01/29/2007 ,- ; F COLUMBUS FAMILY DENTISTRY SitelD: 015-021-002061 ~ Fast Format ~ ~ Site Emergency Factors Overall Sits ~ special Hazaras Utility Shut-Offs 07/24/20075 _ -_ -A) GAS - ~: ---_--- - -- -- -- - - - ~ - --- -- _-° --, -_-.>---- .- --- ___ _-~ - B) ELECTRICAL - C) WATER - NEAR SIDE EXIT D) SPECIAL - NONE E) LOCK BOX - NO i Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLERS. 05/08/20075 Building Occupancy Level 05/08/20075 8 EMPLOYEES -7- Ol/29/2U07 `_,. ~, ,:. F COLUMBUS FAMILY DENTISTRY SiteID: 015-021-002051 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 07/24/2005 ~ NO MSDS SHEETS ON FILE - WASTE PRODUCT ONLY. BRIEF SUMM~~RY OF TRAINING PROGRAM: ROUTINE OPERATION OF X-RAY DEVELOPER. Page 2 Held for Future Use nclu 1VL t uL ULC U.7'C -8- O1/29/Zb07 lM Y + COLUMBUS FAMILY DENTISTRY ___________________________ SiteID: 015-021-002061 + Manager Location: 505 W COLUMBUS .ST City BAKERSFIELD BusPhone: (661) 322-1300 Map 103 CommHaz Minimal Grid: 19B FacUnits: 1 AOV: CommCode: BFD STA 04 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title M SAGHARIA / OWNER AURORA DELEON / MANAGER Business Phone: (661) 32.2-1300x Business Phone: (661) 322=1300x 24-Hour Phone (661) 665-2378x 24-Hour Phone (661) 871-8796x Pager Phone. ( ) - x Pager Phone (661) 835-3872x Hazmat Hazards: React Cont act ,_ _ _ - _ ~ - - -- ------ - Phone:--(661) - 322=1300x - ' ~ _ _ _ MailAddr: 505 W COLUMBUS~ST State: CA City BAKERSFIELD Zip 93301 Owner COLUMBUS FAMILY DENTISTRY Phone: (661) 322-1300x ~ Address 505 W COLUMBUS .ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: ---- ------------------------------------ -------------------------------------- + Emergency Directives: ~ { i ~ ~` PROG H - HAZ WASTE GEN lv LI 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 ete. Signature Date ENT'D J U ~ 2 4 2006 I~D~~ ~ S~pD -1- 05/08/2006 ~~/ r~ V UNIFIED PROGRAM INSPECTION CHECKLIST ~~~~ .SECTION 1: Business Plan and^Inventory Program . ~ BASERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECT ON DATE INSPECTION TIME ADDRESS ~ Q~ ~ Qs~' ~®~ ~ ~~ wS S"'N HONEn ~a C~~- 1 O OF EMPLOYEES FACILITY CONTACT ~~ ~ ~ a ~. U INESS ID NUMBER ,5.02,_ ao~ l Section 1: Business Plan and Inventory Program ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS SIJ ^ APPROPRIATE PERMIT ON HAND . ^ BUSir1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~ , r`' ~D s,? ,~ -----~ ^ CORRECT OCCUPANCY / L V W ,'! i ^ VERIFICATION OF INVENTORY MATERIALS ,~0 ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ ^ 6~ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ~~ 1~^'- ~'w~ Td .~~'-d,rC ~ ~ ~, -r ~, ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND OCEDURES ^ EMERGENCY PROCEDURES ADEQUATE °~ ^ CONTAINERS PROPERLY LABELED ~1 ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? -ICES ^ NO EXPLAIN: - _ QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (881) 326-3978 ~.,e -~~ . Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station q White -Prevention Services Yellow -Station Copy Pink - Buaineae Copy FD2lMe (Rw. lMlOS~ ,_ =~. ~-. CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 ~u,~•~ FACILITY NAME G o ~ u ~ b ~-s ~P ~. ~ t~ ~ e n~"i s~'~ INSPECTION DATE 3 1 ~ ~ Q Sectaon 4: Hazardous Waste Generator Program EPA ID # ^ Routine ~ Combined ^ Joint Agency ^Multl-Agency ^ Complaint ^ Re-inspection OPERATION _ C V COMMENTS Hazardous waste determination has been made EPA ID Number J~ y, 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 r~ q~ ~N 19~ id!~ - 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 ~/ Proper management of lead acid batteries including labels ~ ~~ Proper management of used oil filters N ~ Transports hazardous waste with completed manifest ~C ~.-.:.,- ^~ ,,~, ~„~ ~, f., Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years ~ N^ ~~i ~ Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal =t:ompuance v=vto~latron Inspector: ~~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. - J usiness Site Respo si a Party Pink -Business Copy