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Home My WebLink AboutBUSINESS PLAN 4/15/2007~! ' Kenneth Khuu DDS ~'~ 4100 Empire Dr 110 ,. ; `, KHUU DDS KENNETH Manager KENNETH KHUU Location: 4100 EMPIRE DR 110 City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: 5~1u~' BusPhone: Map 102 Grid: 26D SIC Code: DunnBrad: SiteID: 015-021-002879 (661) 324-5350 CommHaz Minimal FacUnits: 1 AOV: Emergency Contact / Title - Emergency Contact / Title / Business Phone : ~ (Wof )'32 ~ - Sjmx Business Phone : ) - x ( 24-Hour Phone ,(~[, )fly -Zr(l~ x 24-Hour Phone ( ) - x Pager Phone (~ ~) 31 y- - ~Yl/ x Pager Phone ( ) - x Hazmat Hazards: React Contact KENNETH KHUU Phone: (661) 324-5350x MailAddr: 4100 EMPIRE DR 110 State: CA City BAKERSFIELD Zip 93309 Owner KENNETH KHUU Phone: (661) 324-5350x Address 4100 EMPIRE DR 110 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 (~ V~ 1'7 2007 - pR ~N~~p A Cased on my inquiry of those individua~~, responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted a oel'.,ve the information is true, accurate, lete. ~ . ~s- ~7 ign re Date -1- 02/02/2007 ~' 1 F KHUU DDS KENNETH SiteID: 015-021-002879 ~ ~ 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 2.00 GAL Min __ ~ ~/ -2- 02/02/2007 -3- 02/02/2007 T P KHUU DDS KENNETH SiteID: 015-021-002879 ~ ~ Inventory Item 0003 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 T TYPE ~ PRESSURE TEMPERATURE CONTAINER TYPE Liquid 1 Waste I Ambient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 2.00 GAL 2.00 GAL 2.00 GAL - HAZARDOUS COMPONENTS oWt - - -- - -- -- -_ ---~-- - - _ - - --- - - - - Silver No 7440224 11EiGL-1LCL H. 7.7 P~.7 JP71~.1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/02/2007 F KHW DDS KENNETH SiteID: 015-021-002879 ~ Fast Format ~ ~ Notif._/Evacuation/Medical Overall Site ~ yyeiicy ivc~Li=1c:aLic~n y~ ~~ S ~. ---- -_~_ ~ _ ~ r /,~ t 1L6J11V 1VV V1t . ~ L' V QV I.LGL V1V11 y~~ Emergency Medical Plan ~S~n ~~. N~ ~~ -5- 02/02/2007 1~ t F KHW DDS KENNETH SiteID: 015-021-002879 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention , r~ '`~~ ~ S / Release Containment ~r 1 ~~ a .., ~.icaii vN s ~w/ r /.~~r~ vu1Ci tCC~VLLiC:C HCl.1VcLL1CJI1 -6- 02/02/2007 ~, F KHUU DDS KENNETH SiteID: 015-021-002879 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JCC:1d1 I1dGd.L U~ Utility Shut-Offs ~„ -, a-~ya.,c r iva~c.... ~ ravayl rra ~.ci ~ yt~ • tsuilaing occupancy Level. -7- 02/02/2007 ~~ ~R: F KHW DDS KENNETH SiteID: 015-021-002879-~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training , = Page 2 Held for Future Use aiciu ivi L~u~..uic vac -8- 02/02/2007 r i .~~ t~ ~-- UNIFIED PROGRAM INSPECTION CHECKLIST', SECTION 1.: Business Plan and Inventory Program Prevention Services e F R s F , , _„ 900 Truxtun Ave., Suite 210 F)RE Bakersfield, CA 93301 ARTM r Tel.: (661)_326-3979. Fax: (661) -872-2171 - FACILITY NAME ~ ~~~ ~ ~., v~ D ~s ~ ~- INSPECTI N DATE ~ J~3 f o INSPECTION TIME ADDRESS PHONE N0. NO OF EMPLOYEES FACILITY CO NTACT - BUSINESS ID NUMBER 15-021 ~ ~ S -OL>'. p ^ Section 1: Business Plan and Inventory Program ROUTINE ~ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^- RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIr1eSS PLAN CONTACT INFORMATION ACCURATE ~~ ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~~~~ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~~ ^ PROPER SEGREGATION OF MATERIAL `a ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ... ~ f~~ CR ~S r` ~y~~ ~ t~ ~ S ~~ ~` ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? -~J'YES ^ NO EXPLAIN: y~ ~" S~4- t'~ x ~ ~"` S7~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 /' qg Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # Business Site / R ponsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ~`c'~ ,pd ~~ ro~ to .91~ t~ ~ ~J v ~~` r~-- CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME , ~ ~ ~ ~ D~~ INSPECTION DATE ~ ~ ~--3/d T Section 4: hazardous Waste Generator Program EPA ID # t'iX~''`'~ ^ Routine ~ Combined ^ Joint Agency ^MultrAgency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number £ ;.~„ ,P-j 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 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 Transports hazardous waste with completed manifest 1„~ o, ; ,,~ ~-~ t „~ ~ ~+ -~• ~ ~as Sends manifest co tes to DTSC p }- h r} a l~ v+'~ vJ ~ Retains manifests for 3 years S b r~ ~ G~ Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years // Determines if waste is restricted from land disposal =t;omp~~ance v=violation Inspector: ~~~~' ''9 Office of Environmental Services (661) 326-3979 White -Env. Svcs. o~'' Busine Site Responsible y Pink -Business Copy KENNET~i KhUU, D.D.S. • GENERAL COSMETIC • PREVENTIVE CARE . ~~ 4ioo Empire Drive; #iio (Truxtun Ext., next to Yokuts Park) 6akersfield, CA 93309 _Empire Dental Office Apps (66i) 324-5350 Time E-Mail: kennethkkhuu~a aol.com ,~ ,i ~, +~ _ G~~~ ~~ Bakersfield Fire Dept. UNIFIED PROGI~4M INSPECTION CHECKLIST Enironmental services _ ~ 1715 Chester Ave SECTION 1 Business Plan and Inventory Program ~ Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME ,/' "]~~. ~ INSPECTION DATE INSPECTION TIME ___ _ ~~~~~ l_~ -._ ~.~_1 ~-~---- ------------- ---- ------------ -- P~~ ~--- No. of Employees------- ~ADDRESS ----- - ---- - - ~ --- ~~~------ ------ -- a--- ------- - - - -- - - --- - --- - ~------ -- --- - FACILITYCONTACT ~ Business ID Number ITV". I~1~~IN~-"~n ~~-~'1 t~ t~ ,~ D. ~~ ~ - 15-021- Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V nce~ OPERATION tl on \V=Vioa ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ ~ VERIFICATION OF INVENTORY MATERIALS ^ ^ VERIFICATION OF QUANTITIES ^ ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITYE ^ ^ VERIFICATION OF HA'~VIAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^ ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE & ON HAND COMMENTS ANY HAZARDOUS WASTE ON SITE: 1!~ YES EXPLAIN:.. X ~- Y'~ ~ ^ No QUESTIONS REG RDIN THIS INSPECTIONS PLEASE CALL US AT ~66~~ 3Z6-3979 I spector (Please Print) Fire Prevention 1st-InlShift of Site White -Environmental Services Yellow -Station Copy Busi ss Site Resp ` ble Party (Please Print) N Pink -Business opy - ` _ ~+i.-...- .~ _.,.. - - ..