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Home My WebLink AboutBUSINESS PLANi ~~' ~~~ SO. CAL. ORTHOPEDIC _ ~_~ ~~ ! 4105 EMPIRE DRIVE ,- ~~ M~ 39~~~ _ ~"'` Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST H , F R s ,: ~ - n 900Truxtun Ave., Suite 210 ~._ . _ -._.__.~~ u~ ~ F_~~ . __._ _-_. _ ~•-~~-~-~a --~ ~ ~ Fine Bakersfield, CA 93301 ~ ~ _- _ SECTION-1: -Business Pian and Inventory Program _ "R"~ Te>.: (661) 326-3979 ~ ,. - - - ,Fax:- (66 T) 872-2171 FACILITY NAME INSPEC~TI~N DA ~ INSPECTION TIME C) ~~ r +~ lJ~,' ~ c r n i c d'r ~~ O p ~ C ~ .3 ADDRESS ~ ~ ~ ~ ~ ~ ~ /~- P~~G ^~~ ~ NO OF ~v1PLOYEES y C~ f /~ rt FACILITY CONTACT BUSINESS ID NUMBER a 15-021-c~15-dZ,r -c L 5~ ~•~~`~ Section 1: Business Plan and Inventory Program ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (C=Complianoe~ OPERATION V=Violation COMMENTS ~- ^ APPROPRIATE PERMIT ON HAND ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~ ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS S ^ VERIFICATION OF QUANTITIES ~~ ~ ^ VERIFICATION OF LOCATION ~Q~7 ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ~I ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ~ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ ~ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ~ ~~-~~SI -~+ C~'~ ~ ~- ~ y ANY HAZARDOUS WASTE ON SITE? -'~9 YES ^ NO r ~ ~1 EXPLAIN: W j ~ ~ ~~ ~" "' ,Oi fc+~, ~aw~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~ ~~~ ~ Inspector (Please Print) Fire Prevention / 1~' In /Shift of Site/Station # us Hess Site /Responsible Party ( e se Print) White -Prevention Services Yellow -Station Copy - Pink -Business Copy FD 2155. (Rev. 09105 ~'' a ``~~~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~~ OFFICE OF ENVIRONMENTAL SERVICES ~y'0 UNIFIED PROGRAM INSPECTION CHECKLIST ~r•~,~gti~'~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME S U~''l'k~ r ., C ~.l ~ ~f o r +~ + ~ ~ ~}~ a8c ~'c INSPECTION DATE ~~ b Section 4: Hazardous Waste Generator Program ^ Routine ~ Combined ^ Joint Agency EPA ID # ~~`' ~J`"P ~' ^ Multi-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~ ~~~ 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 aze 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 ~~/L Proper management of lead acid batteries including labels f/~ Proper management of used oil filters tv~ A Transports hazazdous waste with completed manifest (~~, ~ ; f ~,~„ ~ ~ ~,-, , ~,,` Sends manifest copies to DTSC 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: C4~G---~~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. usiness Site R s nsible Party Pink -Business Copy SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 Manager JULIE MCGRATH Location: 4105 EMPIRE DR City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: BusPhone: (661) 328-5565 Map 102 CommHaz Minimal Grid: 26D FacUnits: 1 AOV: SIC Code:8011 DunnBrad: Emergency Contact JULIE MCGRATH Business Phone: 24-Hour Phone Pager Phone / Title / OFFICE MANAGER (818) 901-6600x6959 ( ) - x (818) 723-6577x Emergency Contact RAY MIRANDA Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: React Contact JULIE MCGRATH Phone: (661) 328-5565x6959 MailAddr: 4105 EMPIRE DR State: CA City BAKERSFIELD Zip 93309 Owner SOUTHERN CALIFORNIA ORTHOPEDIC Phone: (661) 328-5565x Address 4105 EMPIRE DR State: CA City BAKERSFIELD Zip 93309 Period to Preparers Certif ' d: ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN TotalASTs: _ TotalUSTs: _ RSs: No / Title / (818) 901-6600x1993 (818) 262-8247x ( ) - x ~N~~ ~~ ~ ~ ~~Q1 La^ed an my inquiry of those indivitiuais responsir;ie is~r ccryaininr~ tree information, I certify under r entity o4 iaLv thaf l have perse~na.lly examsnea anrt a~~ familiar with the information submitted and i~~=iiFVe the information is true, _..,,,,:-~te, anti oomtlet ~ignatu e ~ Date Gall Gal -1- 07/16/2007 ~h F SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ ~ 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- 07/16/2007 -3- 07/16/2007 ~, ~ ~ r F SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ Liquid I Waste Largest Container 10.00 GAL TEMPERATURE CONTAINER TYPE Ambient '~STIC CONTAINER AMOUNTS AT THIS LOCATION Daily Maximum 10.00 GAL Daily Average 10.00 GAL rlr~~tucliuu5 ~vl~irvlv~lv~l5 °sWt. RS CAS# Silver No 7440224 riEiGHKL H.7.71",.7.71~1L" 1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min Ambientva Y -4- 07/16/2007 i iti F SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/24/2007 ~ 911 Employee Notif./Evacuation 04/24/2007 VERBAL AND INTERCOM NOTIFICATION. EVACUATION THROUGH FRONT AND EMERGENCY EXITS. Public Notif./Evacuation 04/24/2007 VERBAL AND INTERCOM NOTIFICATION. EVACUATION THROUGH FRONT AND EMERGENCY EXITS. Emergency Medical Plan 04/24/2007 DOCTORS ON STAFF. TRANSPORT TO HOSPITAL. -5- 07/16/2007 ~f F SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/24/2007 ~ SECONDARY CONTAINMENT Release Containment 04/24/2007 SECONDARY CONTAINMENT Clean Up 04/24/2007 ABSORBANT FOR SMALL SPILLS. CALL CALIFORNIA IMAGING OR 911 FOR LARGE SPILLS. Other Resource Activation -6- 07/16/2007 ;=c ~7 ~. F SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~J~JeC:1d1 tldLdlC1~ Utility Shut-Offs 04/24/2007 GAS: E SIDE OF BLDG ELECTRICAL: NE SIDE OF BLDG WATER: N SIDE OF BLDG Fire Protec./Avail. Water FIRE EXTINGUISHERS FIRE HYDRANT: IN FRONT OF BLDG ON EMPIRE 04/24/2007 Building Occupancy Level 04/24/2007 20 EMPLOYEES -7- 07/16/2007 v~ ~,~i F SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 04/24/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: IN-HOUSE OSHA TRAINING. rayc c 1LGlu 1VL L'ul.ul r. vac nc.LU ivi r u~.ulc vac i -8- 07/16/2007 f I~ SA-,=~i ~ S~2 v~ c.~S ~N tlr2~rv~w~.-~~...~ ~~+2'`~~ ~` o ~ 7~2v X N~ ~ ~ ~/~ 1 ~ c!o 1; ./ Z ```lt ,;FLSOUTHERN CALIFORNIA ORTHOPEDIC Manager :.'~ Tv ~•t ~ ~L ~i2'°r-r--t Location: 4105 EMPIRE DR City BAKERSFIELD CommCode: BFD STA O1 EPA Numb: SiteID: 015-021-002254 BusPhone: (661) 328-5565 Map 102 CommHaz Minimal Grid: 26D FacUnits: 1 AOV: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title J. v~ c.4~•oM / C-6~- O~ «- 'f"~ ~ • RAY MIRANDA / Business Phone: (818) 901-6600 x~ Business Phone: (818) 901-6600x1993 24-Hour Phone (818) 9~~6$6~c ~~ 24-Hour Phone (818) 262-8247x Pager Phone ( 18 ) ~'2- ~° ° ^~7 Pager Phone ( 818 ) " ~ ^ `° ~° ~ Hazmat Hazards: React Contact ~~~--~ E 1M LGr2 orTy} Phone : ( 6 61) 3 2 8 -r5.56r_7X' MailAddr: 4105 EMPIRE DR State: CA City BAKERSFIELD Zip 93309 ~ Owner SOUTHERN CALIFORNIA ORTHOPEDIC Phone: (661) 328-ar.~5X'' Address 4105 EMPIRE DR State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN Bassd bn my inquiry cif triouq indivieluais ii th i l f i i i I if f ~~V~9U ~~ ~ iCi ~~~ regpans e r~rr~ut i~n, e or obt<~ rte,~ cert y n n 7 / under penalty of laev thmt I Fzave personally examined and am familiar with the information submitted and believe 4he Information is 4rue, accurate, and complete. S gnature Date -1- 02/06/2007 d~ ~ SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ ~ 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 Minl -2- 02/06/2007 -3- 02/06/2007 ,F~SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ ~ 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: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste -1 Ambient ~ Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10.00 GAL 10.00 GAL 10.00 GAL rit~~titcLwS wi~irviv~:ly l~a %Wt. RS CAS# Silver No 7440224 riAGt1KL ASJL'~~:71~11";1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/06/2007 rF~SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ A~ G l l V Y 1 V V l.. 1 1 1 l~ Cl V 1. V 11 ~ r /.~. ~.:~uiNiVYcc lvvl~ll ~ P~V0.l:U0.1.1V11 i ~-. r uJ.J11t~. ivV Vlt~r,Vdt~U0.l.1 Vll P~lLLC 1..yC11C: ~/ 1"1CUlC:d1 Y1d11 -5- 02/06/2007 • ,: ~ SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ 1ZC.LCQ~7C r,LCVCll l.1 V11 AC1CCi w7G t.Vll l..Q111lllCll 1. l.1 CQ.11 V~J V 1.11C1. 1CCSVUIC.:C 1"~C: l.1 Vdl.1UI1 -6- 02/06/2007 .. ,F SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~j~c~:Lai na~aLUS VL111. 1..y w711UV-VLLa t1LC rL VI~C I:. /L-1V Gill. WCL I..CL Building Occupancy Level -7- 02/06/2007 ., ~_ ~ SOUTHERN CALIFORNIA ORTHOPEDIC SiteID: 015-021-002254 Fast Format ~ Training Overall Site ~ Employee Training Ydy C L Held for Future Use Held for Future Use 9 -8- 02/06/2007 ~G~ ~vx ~ v~J ~. ~v~~ yoJ ~j,~,e~,,~~ C~ q~3aJ . _,