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HomeMy WebLinkAboutBUSINESS PLAN (2)~ALLAGHER FAMILY CHIROPRACTIC TREET 1665 F S [, •. _ ~ GALLAGHER FAMILY CHIROPRACTIC Manager BRETT D GALLAGHER Location: 1665 F ST City BAKERSFIELD SiteID: 015-021-002253 BusPhone: (661) 324-7724 Map 102 CommHaz Minimal Grid: 25D FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:8041 DunnBrad: Emergency Contact / Title Emergency Contact / Title BRETT D GALLAGHER / OWNER / Business Phone: (661) 324-7724x Business Phone: ( ) - x 24-Hour Phone (661) 399-2062x 24-Hour Phone ( ) - x Pager Phone (661) 319-1835x Pager Phone ( ) - x Hazmat Hazards: React Contact BRETT D GALLAGHER Phone: (661) 324-7724x MailAddr: 1665 F ST State: CA City BAKERSFIELD Zip 93301 Owner BRETT D GALLAGHER DC Phone: (661) 324-7724x Address 1665 F ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers Tot alUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~N~~ J U L 1 ~~~ 3ased on my inquiry of those individuals resGOnsibie for oh~aining the information, I certify under penalty of la~v that I have personally examined and am familiar with the information submitted and believe the information is true, omplete. d c accurate, an ~~ ~~ //~~ ti.~'Y~j QC- ~' f 3 0~- Sign~ ure Date -1- 07/11/2007 F GALLAGHER FAMILY CHIROPRACTIC ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-002253 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 5.00 GAL Min -2- 07/11/2007 -3- 07/11/2007 r •~ F GALLAGHER FAMILY CHIROPRACTIC ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit REAR OF BLDG STORE RM SiteID: 015-021-002253 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# Liquid TWaste ~ Ambient~E ~ AmbientT~E ~ PLASTICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL - HAZARDOUS COMPONENTS °sWt. RS CAS# Silver No 7440224 riHGKKL F~5J~5J1~1L"~1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/11/2007 r 7 F GALLAGHER FAMILY CHIROPRACTIC SiteID: 015-021-002253 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/16/2007 ~ 911 Employee Notif./Evacuation 04/16/2007 VERBAL - OWNER/OPERATOR Public Notif./Evacuation 04/16/2007 VERBAL. EXIT OUT FRONT OR BACK DOORS. IJ LIICLI~. C11C: ~/ 1"1C U1C:d1 Y1d11 -5- 07/11/2007 F GALLAGHER FAMILY CHIROPRACTIC SiteID: 015-021-002253 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/16/2007 ~ SECONDARY CONTAINMENT FOR WASTE FIXER. Release Containment 04/16/2007 SECONDARY CONTAINMENT. Clean Up 04/16/2007 PAPER TOWELS AND MOP FOR SMALL SPILLS. 911 FOR LARGE SPILLS. Other Resource Activation -6- 07/11/2007 F GALLAGHER FAMILY CHIROPRACTIC SiteID: 015-021-002253 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ w7Y~'C:ld1 tldGdLU~ Utility Shut-Offs 04/16/2007 GAS: W SIDE OF BLDG ELECTRICAL: S SIDE OF BLDG WATER: FRONT OF BLDG Fire Protec./Avail. Water FIRE EXTINGUISHERS 04/16/2007 Building Occupancy Level -7- 07/11/2007 F GALLAGHER FAMILY CHIROPRACTIC SiteID: 015-021-002253 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 04/16/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: OSHA TRAINING COMPLIANCE rayC ~ Held for Future Use iiciu ivi r u~.utc vac -8- 07/11/2007 r ; ,~ :, + GALLAGHER FAMILY CHIROPRACTIC _______________________ SiteID: 015-021-002253 + Manager Location: 1665 F ST City BAKERSFIELD BusPhone: (661) 324-7724 Map 102 CommHaz Minimal Grid: 25D FacUnits: 1 AOV: CommCode: BFD STA O1 SIC Code:8041 1 EPA Numb: I DunnBrad: --------------------------------- -- ---------------------------- Emergency Contact / Title Emergency Contact / Title / / Business Phone: ( ) - x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact Phone: (661) 324-7724x MailAddr: 1665 F ST State: CA City BAKERSFIELD Zip 93301 Owner ~ Phone: (661) 324-7724x Address: 1665 F ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: - Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~~ JU N p 8 240 6 Based on my i~~uiry s5f three individuals responsible for obtair~~n~ the information, I certify under penalty of law that I have p®rsonally examined and am familiar with the information submitted and believe he information is true, accurate, and com et . r ~3~ Signature Date -1- 05/17/2006 ~~ !` .. GALLAGHER FAMILY CHIROPRACTIC 3q~3b SiteID: 015-021-002253 Manager 13~~7- ~ ~aAtLAG~1~~ ~< <- Location: 1665 F ST City BAKERSFIELD CommCode: BFD STA O1 EPA Numb: BusPhone: (661) 324-7724 Map.: 102 CommHaz Minimal Grid: 25D FacUnits: 1 AOV: SIC Code:8041 DunnBrad: Emergency Contact f Title Emergency Contact / Title g,//dCC~T-D. ~,~t~6~lfJ~ / a.~E~ / Business Phone: (~! ) 3Z`/ -~`/x Business Phone: ( ) - x 2 4 -Hour Phone (~ ) 3 g g -Zo6i x 2 4 -Hour Phone ( ) - x Pager Phone (~ ) 3/9 - 135 x Pager Phone ( ) - x Hazmat Hazards: React Contact ~/t~tJ-D_ ~~ ~~~~~~ Phone: (661) 324-7724x MailAddr: 1665 F ST State: CA City BAKERSFIELD Zip 93301 Owner Phone: (661) 324-7724x Address 1665 F ST State: CA City BAItERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~N~g~ ~~~ ~: ~ Q~7 Based on my inquiry of these individuals the informatio ~ y e rsonall responsible for obtaining f law that I have p under penalty o ue t o 'l r is the~nformation d b lieve e ubrrii t d an s lete. p and com te , accura ~~ ~ ,~.L`o--~- `~Z ~ ~- ,~~ pa e re i g S -1- 01/31/2007 F GALLAGHER FAMILY CHIROPRACTIC SiteID: 015-021-002253 ~ ~ 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 5.00 GAL Min -2- 01/31/2007 -3- 01/31/2007 F GALLAGHER FAMILY CHIROPRACTIC SiteID: 015-021-002253 ~ ~ 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: REAR OF BLDG STORE RM CAS# Liquid Waste I AmbRent~E ~ AmbientT~E ~ PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container .Daily Maximum I Daily Average 5.00 GAL 5.00 GAL 5.00 GAL rir~~titcl~vu5 ~vrirulvrlv'1'S %Wt. RS CAS# Silver No 7440224 riHL.L~![L a'-~~SL"SS1~1L"1V'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 01/31/2007 r. , F GALLAGHER FAMILY CHIROPRACTIC SiteID: 015-021-002253 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification // Employee Notif./Evacuation ~ ° ~ 10~) r-- S o 1 ~w~~ny~~ Public Notif./Evacuation ~-~ ~ ~ ~. 1 C.~ V ~y r Luic.~ycii~.Y a-acui~.ai riati -5- 01/31/2007 F GALLAGHER FAMILY CHIROPRACTIC SiteID: 015-021-002253 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 1CC1CdaC L.V111~d111IlIClll.. S ~cc~"~ ~ ~ '~ ~ CU ."~.~..4 ~ .~ r. a..,~ L.IG0.11 Vj.J ~ ~ ~ '~~~ ~ ~ ~s ~ s~,1 j ~ V1.11GJ. iCC.`7V1A1_C:C t1C:l.1Vdl.1V11 ~ -6- 01/31/2007 i• F GALLAGHER FAMILY CHIROPRACTIC SitelD: 015-021-002253 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aY~~l.al nac,ctl.u~ Utility Shut-Offs ~~ W ~~~~ Sam ~ s~ ~~ a-E ~"~ c~ J-6 Sc ~ C o~ ~ ~. c «.,..... "~ 1 1 pl iw i~iic riv~..ci.. / rava.i.i . vva~.ci Building Occupancy Level -7- 01/31/2007 i a' F GALLAGHER FAMILY CHIROPRACTIC SiteID: 015-021-002253 ~ Fast Format ~ ~ Training Overall Site ~ P~lll~Jl Vy CC tIC1111111y rcxyC ~ r Held for Future Use nvl.u 1.Vt ru~uiC VAC -8- 01/31/2007 ~/ ~ _" ~~ , Ulv~l~l~'D PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program ~' Prevention Services F R s e , °~ , „ 900 Truxtun Ave., Suite 210 FIRE ~- Bakersfield, CA 93301 S aRrM mr Tel.: (661) 326-3979 ~~a~^~ . ;~ . _; ~- ' ~ Fax: (661} 872-2171 FACILITY NAME ~c+t~~~S°r ~~..n..~~ C4-•fd raGT1 INSPEC ION DATE ~ f.b'd.. INSPECTION TIME ADDRESS j. , I ~'~S ~ P~ON~JJO. ~ -7 Z' NO OF EMPLOYEES sr 2 ~ FACILITY CONTACT BUSINESS ID NUMBE 15-021-at S- o Z-1 -oa Section 1: Business Plan and Inventory Progt-am ^ ROUTINE ~ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ L'9 APPROPRIATE PERMIT ON HAND /ti_l ~ ~~,~ N~ ~ d7~~,"I -r ~"v, C'~GrL~~ ~/'° ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~0 ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL .... . ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^~'LI HOUSEKEEPING gg © ~ j ^ FIRE PROTECTION X+7 ^ SITE DIAGRAM ADEQUATE & ON HAND ~3 e q°ei~, ANY HAZARDOUS WASTE ON SITEv ~YE$ ^ NO EXPLAIN: ~a-'s~"'~ ~~ uC2- QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326.3979 Inspector (Please Print) Fire Prevention / 1s' In /Shift of Site/Station # . _. ~ ~, Business / esponsible Party (Please Print) White -Prevention Services _ Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 a Wit. /S. ` ~'~~`~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~ OFFICE OF ENVIRONMENTAL SERVICES b •''' UNIFIED PROGRAM INSPECTION CHECKLIST ~'~gtirt~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME ~ °t ~ ~ 4 She ~ ~~ ~~y G,^~~©~~a~N INSPECTION DATE ~"' 1 6 I a1 Section 4: hazardous Waste Generator Program EPA ID # ~~'^'P~ ^ Routine ~ Combined ^ Joint Agency ^Mulri-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number X~ y,,,, i0 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 JV ~ 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 N /~ Proper management of used oil filters /1J ~.1 Transports hazazdous waste with completed manifest Sends manifest copies to DTSC M ~ ~~ Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years /v' Determines if waste is restricted from land disposal c.:=~:ompuance v=v~otatton Inspector: G ~~ X- ^~> Office of Environmental Services (661) 326-3979 White -Env. Svcs. Pink -Business Copy ~~ Busine Site Responsible Party