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Home My WebLink AboutBUSINESS PLANM I~~ MED IMAGING CTR 4000 EMPIRE DRIVE #100 I ' P I ~~ f "1 MEDICAL IMAGING CTR-BKSFLD SiteID: 015=021-0008$ Manager ~oc~eS~i" ~`~~Ctf'~ BusPhone: (661) 395-0155 Location: 4000 EMPIRE DR 100 Map 102 CommHaz Minimal City BAKERSFIELD Grid: 26D FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: CAL912693010 SIC Code: DunnBrad: Emergency Contact / `Title c~(~em~`oy15 " ' ~ ~ Emergency Contac~,, / Ch~i ~" ~e Title ~R£-Y-Gn.,RxiERM~~ - / ~rBM3-i33-S f R~-TO ~t/-<< ° ~ ~IA~rY--~~A~D Eld re / c4 CLINICAL COORS Business Phone:5 ( 61) 395-0155x Business Phone: (661) 395-0155x 2 4 -Hour Phone (6 61 } ~-r-g~--~,-v~ g~ 2-~} 2 4 -Hour Phone (6 61) ~~---4~-6fsx $~ 3 (~~ Pager Phone (661)-X83-~~8~ gpq~~p Pager Phone (661) 8.9~-~6~{~~8x3 42-SR ............... Hazmat Hazards: React .............. Contact - Phone: (661) 395-0155x MailAddr: 4000 EMPIRE DR 100 State: CA City BAKERSFIELD Zip 93309 ............... ~ ~ '~' ~ ~ ~ S O ~ ~ )2$2 _ 6 p00 x 250 C-n-k..rpr Address : ~ GA i ce 0 ~ State : City W6C3DLA~D~-H3-LLS- ~ {c ~ ~ Zip 63D - gya5 °- ~ 913 6 7 - 2 4 0 7 . .............. Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: ............. Emergency Directives: PROG H - HAZ WASTE GEN Based on my inquiry of those individuals responsible for obtaining the information, !certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~N~~ ~:~~ ~ ~ ,~Q07 Signature Date -1- 01/29/2007 ,; t F MEDICAL IMAGING CTR-BKSFLD SiteID: 015-021-00084 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit 1~ICP WASTE FIXER R L 15.00 GAL fain -2- O1/29/~007 -3- Ol/29/~007 MEDICAL IMAGING CTR-BKSFLD Si D 015 02 43 F teI : - 1-0008 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Sites ~ COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Sits 365 Location within this Facility Unit Map: Grid: DARKROOM CAS# STATE T TYPE PRESSURE - TEMPERATURE CONTAINER TYPE Liquid I Waste ~ Ambient ~ Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ~ Daily Average 10.00 GAL 15.00 GAL 15.00 'GAL I1tlGt~iC.LVl1J 1~V1~lY V1V P~1V1J ~Wt. RS CAS# Silver No 7440224 rlti[~riRL 1-x. 7 JI;J Jl`7L'1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# M~C1~ No No No No/ Curies R / / / Mi -4- O1/29/2d07 F MEDICAL IMAGING CTR-BKSFLD SiteID: 015-021-00084$ ~ Fast Form~it ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification Ol/31/199f3 ~ CALL 911 Employee Notif./Evacuation 10/24/20E76 PERSONNEL ARE TO NOTIFY THE BFD AND IMMEDIATELY EVACUATE THE CENTER. Public Notif./Evacuation ONLY IMMEDIATE ROOM NEED BE EVACUATED O1/31/199b Emergency Medical Plan 10/24/20176 A SPECIFIC PLAN EXISTS FOR DIFFERENT TYPES OF EMERGENCIES AND THE EVACUATIC71~1 IS ALWAYS TO THE WEST SIDE OF THE BUILDING. IN THE CASE OF INURY, PHYSICIANS AND NURSES ARE ALWAYS ON DUTY. CLOSEST LOCAL HOSPITAL IS ti,Ttir T rRL~TR/1DTTr LT~ICDTTZIT ~Q~ 'r x xaazr-::ar:.~~r ~( ~P(-,-G~.~.. ~ YGL.X•7-L~.~e -5- Ol/29/2b07 F MEDICAL IMAGING CTR-BKSFLD SiteID: 015-021-00084 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Sites ~ ~ Release Prevention Release Containment 01/31/199b SHUT OFF GA5 dean up VLiler xeSVUr"Ce ACL1VaL10i1 -6- ~ O1/29/2b07 F MEDICAL IMAGING CTR-BKSFLD SiteID: 015-021-00084E3 ~ Fast Form~€ ~ ~ Site Emergency Factors Overall Site ~ special riazaras = Utility Shut-Offs Ol/29/20(~7 A) GAS - ~~ B) ELECTRICAL - NE CRNR NEXT TO STAIRS C) WATER - REAR OF BLDG D) SPECIAL - NONE E) LOCK BOX - NONE Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM AND FIRE EXTINGUISHERS FIRE HYDRANT - ACROSS ST NW SIDE AND REAR OF BLDG O1/29/20~7 Building Occupancy Level 02/28/20f)5 < <P ~ EMPLOYEES -7- Ol/29/~~07 it - rs F MEDICAL IMAGING CTR-BKSFLD SitelD: 015-021-0008~~3 ~ Fast Format ~ ~ Training Overall Sits ~ ~ Employee Training 10/24/20076 ~ MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING PROGRAM: STAFF INFORMED ABOUT HAZARDS DURING INSERVICE MEETINGS. Page z tieia =or r~uzure use rieia =or ruLUre use -s- 01/29/Ztio~ rv~ ~: ~. MEDICAL IMAGING CTR-BKSFLD BusPhone: Map 102 Grid: 26D SiteID: 015-021-000848 Manager MODESTA M STUGARD Location: 4000 EMPIRE DR 100 City BAKERSFIELD CommCode: BFD STA O1 EPA Numb: CAL912693010 SIC Code: DunnBrad: (661) 395-0155 CommHaz Minimal FacUnits: 1 AOV: Emergency Contact / Title Emergency Contact / Title MODESTA M STUGARD j OPS MANAGER CHRISTINE ELDRED / CLINICAL COORD Business Phone: (661) 395-0155x Business Phone: (661) 395-0155x 24-Hour Phone (661) 872-4606x 24-Hour Phone (661) 831-5605x Pager Phone (661) 809-6908x Pager Phone (661) 342-5950x Hazmat Hazards: React Contact MODESTA M STUGARD Phone: (661) 395-0155x MailAddr: 4000 EMPIRE DR 100 State: CA City BAKERSFIELD Zip 93309 Owner INSIGHT HEALTH CORP Phone: (949) 282-6000x Address 26250 ENTERPRISE CT 100 State: CA City LAKE FOREST Zip 92630-8405 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN i3ased on my inquiry of those individuals responsible for obt~~ining the information, I certify under penalty of ialy that I have personally examinod and am familiar ~srith the information submitted and h?lieve the information is true, acc irate, ~ d complet :. ~~ Signature a fJ t a e ~~ ~ ~~~~ -1- 07/12/2007 s ~~ ,. F MEDICAL IMAGING CTR-BKSFLD SiteID: 015-021-000848 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 15.00 GAL Min -2- 07/12/2007 -3- 07/12/2007 F MEDICAL IMAGING CTR-BKSFLD ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit DARKROOM STATE TYPE PRESSURE Liquid Waste Ambient AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10.00 GAL 15.00 GAL 15.00 GAL ti1~G1-1tCLVU~ l;lJl~ir~lv~lvl5 °sWt. RS CAS# Silver No 7440224 nr~~r~ttL ti~~~aari~ivl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min SiteID: 015-021-000848 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# i TEMPERATURE CONTAINER TYPE Ambient ~ PLASTIC CONTAINER -4- 07/12/2007 it 1 F MEDICAL IMAGING CTR-BKSFLD SiteID: 015-021-000848 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 01/31/1990 ~ CALL 911 Employee Notif./Evacuation 10/24/2006 PERSONNEL ARE TO NOTIFY THE BFD AND IMMEDIATELY EVACUATE THE CENTER. Public Notif./Evacuation ONLY IMMEDIATE ROOM NEED BE EVACUATED 01/31/1990 Emergency Medical Plan 02/22/2007 A SPECIFIC PLAN EXISTS FOR DIFFERENT TYPES OF EMERGENCIES AND THE EVACUATION IS ALWAYS TO THE WEST SIDE OF THE BUILDING. IN THE CA5E OF INURY, PHYSICIANS AND NURSES ARE ALWAYS ON DUTY. CLOSEST LOCAL HOSPITAL IS MERCY HOSPITAL, TRUXTUN AVE. -5- 07/12/2007 'r i P MEDICAL IMAGING CTR-BKSFLD SiteID: 015-021-000848 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 9 Release Containment 01/31/1990 SHUT OFF GAS ~icaii vN Other Resource Activation -6- 07/12/2007 "i~ ~i F MEDICAL IMAGING CTR-BKSFLD SiteID: 015-021-000848 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _, .~Nc~..~.ai nac~aiu~ Utility Shut-Offs 01/29/2007 A) GAS - REAR OF BLDG B) ELECTRICAL - NE CRNR NEXT TO STAIRS C) WATER - REAR OF BLDG D) SPECIAL - NONE E} LOCK BOX - NONE Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM AND FIRE EXTINGUISHERS FIRE HYDRANT - ACROSS ST NW SIDE AND REAR OF BLDG 01/29/2007 Building Occupancy Level 02/22/2007 16 EMPLOYEES -7- 07/12/2007 -~ ~ ~ F MEDICAL IMAGING CTR-BKSFLD SiteID: 015-021-000848 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/24/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUNIl~IARY OF TRAINING PROGRAM: STAFF INFORMED ABOUT HAZARDS DURING INSERVICE MEETINGS. rays ~ Held for Future Use Held for Future Use -8- 0~/12/200~