The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLANPrevention Services UNIFIED PROGRAM FNSPECTION CHECKLIST' H A E R s F , D 900Truxtun Ave., suite 210 ~3~,. ~ _.__-~ --.-__ .~.~~,. ~~,~ ~~~ s~ .~_~ .. _-_____ A___~.,, ~ ~~ ~ ~._ _~~.Q~~. ____ Fi,i:F ~ Bakersfield, CA 9330.1 SECTION 1: Business Plan and_Inventory Program "Rr'" Tel.: (661) 326-3979 Fax:. ' (661) 872-2171 FACILITY NAME Gh ~ O 1 ~ '~ ~~ INSPECTION DATE ~ S1 f INSPECTION TIME r ~:~,~~~ s a~. a o • c s o ffi , ADDRESS ~ 252s ~ ~ s~ 3z~-~~~ ~~ PHONE NO. NO OF EMPL YEES. FACILITY CONTACT BUSINESS ID NUMBER 15-021-8~ 5-(~Z)-O 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 PERMlT ON HAND L ~ 11 c~ y ,~~, a- U ~~ ~ t w ~ /b ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE `'' W ~C' h Ut•'+ Y1i C~ ~. ~~ ^ .VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ~N I+V [1v 1 ^ ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES s - ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^~ FIRE PROTECTION ~~~) ~ yy..y/..~ y~ ~r` l Y ~ \ ~if..I ^ SITE DIAGRAM ADEQUATE & ON HAND Z 33~ ~~31 ~C ANY HAZARDOUS WASTE ON SITE? L7 YES ^ NO EXPLAIN: `~ ~~- ' ~~ -~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (667) 326-3979 ~~2~. Inspector (Please Print) Fire Prevention / 1~` In /Shift of Site/Station # Busi ss Site / p Bible Part Please Print) - White -Prevention Services - - Yellow -Station Copy _ Pink -Business Copy - FD 2155 (Rev. 09/05 ~~ . ~ o~~~`- •~~`~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~~ ~ OFFICE OF ENVIRONMENTAL SERVICES ~~ •y UNIFIED PROGRAM INSPECTION CHECKLIST °=a~~p~ 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME G^ ~ ~ r~ ~ ~t-S IS ~.~ O ~1- ~ ~ IP~ ~ ~ INSPECTION DATE ~ a ' Section 4: Hazardous Waste Generator Program EPA ID # ~~~''`~' ~~ ^ Routine ~ Combined ^ Joint Agency ^Muiti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~~~ jy Authorized for waste treatment andlor 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 _ / N Proper management of lead acid batteries including labels of Proper management of used oil filters /'~ ~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC ~p,,,, ~-C` d ~ ~ ~ Retains manifests for 3 years ~ a, t k ~a Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years ~ Determines if waste is restricted from land disposal ~=~,ompuance v=v~otanon Inspector: ~ r ~~/LK- r r 1 Office of Environmental Services (661) 326-3979 White -Env. Svcs. Pink -Business Copy Bus ness Si esponsible Party ~., :~ CHANNEL ISLANDS ORTHOPEDIC GRP Manager LICHA CASTANIERO Location: 2525 EYE ST B City BAKERSFIELD SiteID: 015-021-002331 BusPhone: (805) 988-6510 Map 103 CommHaz Minimal Grid: 30A FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title LICHA CASTANIERO / MANAGER / Business Phone: (661) 988-6510x133 Business Phone: ( ) - x 24-Hour Phone -(661) 279-5934x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x ................ Hazmat Hazards: React Contact LICHA CASTANIERO Phone: (~~s)o?~f' ~9'3~k MailAddr: 2525 EYE ST B State: CA City BAKERSFIELD Zip 93301 Owner CHANNEL ISLANDS ORTHOPEDIC GROUP Phone: (805) 988-6510x Address 2525 EYE ST B State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = dal Preparers TotalUSTs: = dal Certif~d: RSs: No ParcelNo: ............... Emergency Directives: PROG H - HAZ WASTE GEN ENT's ~ ~ ~ ,~QQ7 t~g~~d tan my inquiry of those individuals respan8ible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and elieve the information i true, accurate, and c plete. 51 nature Date -1- Ol/29/Z007 ~. F CHANNEL ISLANDS ORTHOPEDIC GRP SiteID: 015-021-002331 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit t~I~P WASTE FIXER R L 5.00 GAL lain -2- Ol/29/~007 '3' Ol/29/~007 F CHANNEL ISLANDS ORTHOPEDIC GRP SiteID: 015-021-00231 ~ ~ 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: ---- DARKROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste -~mbient ~ Ambient `~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 5.00 GAL 5.00 GAL 5.00 GAL tiAGt~ttLV U 5 1.:u1~lrulv.N;ly •1~5 oWt. RS CAS# Silver No 744024 riHGHKL AJ 51'~J51~1~1V"l~~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MC1 No No No No/ Curies R / / / Mrl -4- 01/29/2007 F CHANNEL ISLANDS ORTHOPEDIC GRP SiteID: 015-021-002331 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 05/12/2006 ~ CORPORATE OFFICE NOTIFIED BY PHONE. Employee Notif./Evacuation 11/04/20174 POSTED EVACUATION SIGNS FOR EMERGENCY EXITS; VERBAL OVERHEAD ANNOUNCEMENT 'I`O EVACUATE. Public Notif./Evacuation 05/12/20t~6 CALL 911. Emergency Medical Plan 05/12/20076 INJURED EMPLOYEES ARE TO BE TRANSPORTED TO SAN JOAQUIN VALLEY HOSPITAL. -5- O1/29/~007 i. F CHANNEL ISLANDS ORTHOPEDIC GRP SiteID: 015-021-00231 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/12/2006 ~ THE X-RAY MATERIAL IS STORED IN A BARREL WHICH HAS A SECONDARY CONTAINER ASS A BACK-UP SAFETY MEASURE. SOURCE ONE COMES ONCE A MONTH TO CLEAN THE CONTAINER AND TWICE A MONTH TO EMPTY THE CONTAINER. Release Containment 11/04/2004 SECONDARY CONTAINER. Clean Up 05/12/20[)6 NO PLAN IN PLACE, AS THE SECONDARY CONTAINER PROTECTS THE EXPOSURE OF CHEMICALS BY BACKING UP THE PRIMARY CONTAINER. v~,llc1. icc~vui~c til:l.lVCLl.1V11 -6- O1/29/Z007 ~~ F CHANNEL ISLANDS ORTHOPEDIC GRP SiteID: 015-021-00231 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ apeciai nazaras Utility Shut-Offs 05/12/2006 PROPANE/NATURAL GAS - N/A GAS - BACK OF BLDG R SIDE ELECTRICAL - BACK OF BLDG R SIDE WATER - BACK OF BLDG LOCK BOX - NO Fire Protec./Avail. Water O1/29/20t7`7 PRIVATE FIRE PROTECTION - BUILT-IN SPRINKLERS IN EVERY ROOM AND THREE FIRE EXTINGUISHERS: ONE R FRONT OF OFFICE, ONE BACK L SIDE OF OFFICE, AND ONE L MIDDLE SIDE OF OFFICE. FIRE HYDRANT - FRONT OF BLDG OUTSIDE L OF MAIN ENTR. Building Occupancy Level ~. T ~ V v ~, -~- 0l/29/~Oo~ _~ F CHANNEL ISLANDS ORTHOPEDIC GRP SiteID: 015-021-002331 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/20/2006 ~ BRIEF SUMMARY OF TRAINING PROGRAM: EVACUATION PRACTICE, AS WELL AS GENERAL INFORMATION ABOUT EVACUATION, EMERGENCY SUPPLIES, EXITS, SHUT-OFF VALVES ETC PROVIDED ONCE A YEAR TO EMPLOYEES. rays a rseia iur ruti,ure use nclu iui ru~uic use -8- Ol/29/Z007