HomeMy WebLinkAboutBUSINESS PLANi
i- _
MERCY HOSPITAL
~ _ - - - -- !, 1600 DSTREET -
~~
+ CATHOLIC HEALTHCARE WEST HIR _________________________ SiteID: 015-021-002934 +
Mana er : ~ dN~~ ~~ ~~~- - ~~ 7~
g ~ '~"g- BusPhone : ( 661)
Location: 1600 D ST Map 102 CommHaz High
City BAKERSFIELD Grid: 25D FacUnits: 1 AOV:
CommCode: BFD STA O1
EPA Numb:
SIC Code:8049
DunnBrad:.
Emergency Contact / '~"it~e Emergency Contact / Title
CHARLIE BOYLES /'jtglrj'62 l KEN STONECIPHER / A1R~c~~~ o~~Gi'Z-~
Business Phone: (661) 632;-5144x Business Phone: (661) 632-5872
24-Hour Phone ( 6(o j) `e7j~~jc~~ 24-Hour Phone ( ) ~0~~7d~o ~r
Pager Phone (~~~} ~ Pager Phone ((~~() ~~7 ~/[~ ~
Hazmat Hazards: Fire ImmHlth
Contact CHARLIE BOYLES Phone: (661) 632-5144'
MailAddr: 2215 TRUXTUN AVE, State: CA
City BAKERSFIELD Zip 93302
+- i-~G~C Ff~~ ~l~`--~_ - - - - - - -Phone : - - ~~~ - ~~~-. ;~'~a- - - -+
Owner --~ ~, ~ ~~ ~ ~, ~ ~ __
Address ~ j$.~ ~R2y ~-, ~~~~ ~ State : CA
City S4~'I~~/Sc3 ~4- Zip -9" ~- ~~10"!
+--------------------------------------j----------------------------------------+
Period to
Preparers
Certif'd:
ParcelNo:
TotalASTs: = Gal
TotalUSTs: = Gal
RSs: No
Emergency Directives:
PROG,A - HAZMAT
PROG T - ABOVEGROUND STORAGE TANK
~ ~~y ~
~~~~
Based on my inquiry of those individuals
responsible for obtaining the jnformation, I certify
under penalty of law that 1 have personally .
examined and am familiar with the information
submitted and be 'eve the information is true,
ac ur , and co pl f . Cy /'
~~/ ~~tO
ENrsp SUN ® 2
2006
-1- 02/28/2006
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (6611326-3979
FACILITY NAME
FACILITYCONTACT
.N 0.
PHONE No. No. of Employees
---------- ~ 3~ - s~- ~_ ~b
--- ---- __._ ----.....-....--------
Business ID Number
i s-oa I - a~ aqs
Section 1: Business Plan and Inventory Pn~gram
Routine ^ Combined ~ Joint Agency ^Mu1ti-Agency O Complaint ^ Re-in c
7Qp§
~% V \ V=Vio atlonnce ~ OPERATION
(,,~/ ^ APPROPRIATE PERMIT ON HAND
LJ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
C7 ^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY
^ (~ VERIFICATION OF INVENTORY MATERIALS
L!!" ^ VERIFICATION OF QUANTITIES
1.3t' ^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
r -------------- -- -- ------------.._..-----
l~f ^ VERIFICATION OF MSDS AVAILABILITYE
~J ---- -- -- - --- -- -- _-----...- -- _--- --
L?l ^ VERIFICATION OF HAT MAT TRA{N{NG
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
^ EMERGENCY PROCEDURES ADEQUATE
L~7 ^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
i~ ^ FIRE PROTECTION
-,-,-. -J - - -- ----------- ------------------._.----- ---------
L~ ^ SITE DIAGRAM ADEQUATE S~ ON HAND
COMMENTS
ANY HAZARDOUS WASTE ON SITE: ^ YES CrT IVO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTIO PLEASE CALL US AT (BG1} 3ZF)-397
l
t
Ins ct~
pe Badge No., usln s Site
White • Environmental Services Yellow -Station Copy Pink • Business Copy
UNIFIED PROGRAM INSPECTION CH-ECKLIST
SECTION 1: Business Plari and Inventory Program
•
Prevention Services
A E R s F . n- 900 TrUxtun Ave., Suite 210
F~aE Bakersfield-; CA 93301
ARTM T Tel.: : (661) 326-3979
661
872
2171
Fax
)
-
: (
FACILITY ME ! '~(L
t `~ 0~~.~ ~- r~~ t INSPECTION D
~~ ~~ T
~ INSPECTION TIME
~O~
ADDRESS
QO ~ PHONE NO``. Q
' (~ 2 ~-\1 NO OF EMPLOYEES
FACILITY CONTACT
~h ~
~`~ BUSINESS ID NUMBER
15-021- b~
~
Section 1: Business Plan and Invento Pro ram y ~~
rY g ~~
~_ _.
ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ( C=Compliance OPERATION
V=Violation COMMENTS
^ APPROPRIATE PERMIT ON HAND
^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS
y~ ^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS ~ -
^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
^ VERIFICATION OF MSDS AVAILABILITY
^ VERIFICATION OF HAZ MAT TRAINING
~
~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
,
,~/
ll3. ^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
'~ ^ FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN
^ YES ~' NO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
In e t~se Print) Fire Prevention / 1s' In /Shift of Site/Station #
~P~~~c ~~'y~S
B ~ es ite / Re onsible rty (Pleas ~ t)
C
hit -Prevention Services Yellow -Station Copy Pink -Business Copy.
FD 2155 (Rev. 09/05