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Home My WebLink AboutBUSINESS PLAN 7/12/2007C COMFORT DENTAL - 2631-A FASHION PLACE i ~. ~ _; v ~~. COMFORT DENTAL FAMILY SiteID: 015-021-003011 Manager ELIZABETH SERRANO Location: 2631 FASHION PL A City BAKERSFIELD BusPhone: (661) 871-2223 Map 103 CommHaz High Grid: 22A FacUnits: 1 AOV: CommCode: BFD STA 08 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title SAEKYU OH DMD / OWNER ELIZABETH SERRANO / MANAGER Business Phone: (661) 871-2223x Business Phone: (661) 871-2223x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661) 600-2468x Pager Phone (661) 619-0421x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact SAEKYU OH DMD Phone: (661) 871-2223x MailAddr: 2631 FASHION PL A State: CA City BAKERSFIELD Zip 93306 Owner 5AEKYU OH DMD Phone: (661) 871-2223x Address 2631 FASHION PL A State: CA City BAKERSFIELD Zip 93306 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT B^:,~d on my inquiry of those individuals resNnn~i~~ie for oLtaining the information, I certify under penalty of law t hat f have personally eramined and am famil iar with the information submitted and believe the information is true, accurate, and ~umplete. ~I~~~ Si ~ ture ~ Date -1- 07/10/2007 F COMFORT DENTAL FAMILY SiteID: 015-021-003011 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP NITROUS OXIDE F P IH G 512.00 FT3 Hi OXYGEN F IH DH G 1004.00 FT3 Low HELIUM F P IH G 219.00 FT3 Min -2- 07/10/2007 -3- o~/io/aoo~ ,~ F COMFORT DENTAL FAMILY SitelD: 015-021-003011 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME NITROUS OXIDE Days On Site 365 Location within this Facility Unit Map: Grid: GAS CLOSET CAS# 10024-97-2 STATE T TYPE PRESSURE TEMPERATURE CONTAINER TYPE ~GaS I Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 256.00 FT3 512.00 FT3 _ 512.00 FT3 tiAGt1KUV UJ wl~irvlv~ly 1 ~ %Wt. RS CAS# 100.00 Nitrous Oxide No 10024972 t1HGL-~KL E~~~~JJ1~1L'1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit GAS CLOSET STATE TYPE PRESSURE _ Gas ~ureAbove Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 251.00 FT3 1004.00 FT3 1004.00 FT3 nnG[-j.[t1JVUJ ~.v1~1rv1VtSlVla %wt. Rs cAS# 100.00 Oxygen, Compressed No 7782447 I1HGtitCL H.7 Jr+JJ1v1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 07/10/2007 r F COMFORT DENTAL FAMILY SiteID: 015-021-003011 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: GAS CLOSET CAS# 7440-59-7 STATE T TYPE PRESSURE -~ TEMPERATURE ~~ CONTAINER TYPE ~GaS I Pure Above Ambient I Ambient I PnRT _ PRFS~ _ C'YT~TT~TT)F.R I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 219.00 FT3 219.00 FT3 219.00 FT3 HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Helium No 7440597 ruiarutL r~a a~aai~i~ivla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 07/10/2007 F COMFORT DENTAL FAMILY SiteID: 015-021-003011 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification ,_ L'lll~JlVyCC 1VV 1.11. ~ L' VdC~Udl~l V11 _i_ ~ /.~. r U!/l l 1. 1V V V 1 L . ~ J:I V 0.~.. U0. 1..1 Vll LPL ILCly Clll.Y 1.1C l.ll l:dl x10.11 -6- 07/10/2007 F COMFORT DENTAL FAMILY SiteID: 015-021-003011 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ 1CC1Cd~C t'1_CVC111.1V11 Release Containment ,., ~..LCaii VN V1.11C1 1CC5VUI l:C 1il.: l.lVdl.l Vll -7- 07/10/2007 F COMFORT DENTAL FAMILY SiteID: 015-021-003011 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~~c~.iai naaalu~ V1.1111.y J11U1.-V11S r 1.LC t'L VI.CC/HVd11 Wcl l,~1 DU11U1i1C~. occupancy Level -8- 07/10/2007 z ~ ;~ F COMFORT DENTAL FAMILY SitelD: 015-021-003011 ~ Fast Format ~ ~ Training Overall Site ~ L~l ll~J1V~/CC 1Id1i11i1C~. r ayc c. Held for Future Use Held for Future Use -9- 07/10/2007 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program • r 1 A E R S P I P F/RE ARTM T Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME I G o~o /~e ~-~1,~-~i INSPECTION DATE ~-~ - o.G INSPECTION TIME o 36 ADDRESS oZ ~4 SGt t o U (~ PHONE NO. ~ ~ 1 ~~ NO OF EMPLOYEES ld FACILITY CONTACT ~II` ~ Sew ' BUSINESS ID NUMBER 15-021-~7~3 ®~~ __ __ 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 ^ BUSIfIeSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY O ,~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES I ~ ^ 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 '~°- ^ HOUSEKEEPING ^ FIRE PROTECTION i~, ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN ^ YES ~NO QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Pri ) Fire Prev lion / 1~I In /Shift of SitelStation # siness Site esponsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 i + COMFORT DENTAL FAMILY _______________________________ SiteID: 015-021-003011 + Manager SAEKYU OH DMD Location: 2631 FASHION PL A City BAKERSFIELD BusPhone: (661) 871-2223 Map 103 CommHaz High Grid: 22A FacUnits: 1 AOV: CommCode: BFD STA 08 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title SAEKYU OH DMD / OWNER Qr Z2~~-!•~ SP,.vr~t,~t b / M~I~Q~' ~ Business Phone: (661) 871-2223x Business Phone: (t~(~I )$71 -2~-a3x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (l~tv ( ) u bo - ~4~8 x Pager Phone (t~.t¢. ~ ) CP 1~ - b4~ t x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact SAEKYU OH DMD Phone: (661) 871-2223x MailAddr: 2631 FASHION PL A State: CA City BAKERSFIELD Zip 93306 Owner SAEKYU OH DMD Phone: (661) 871-2223x Address 2631 FASHION PL A State: CA City BAKERSFIELD Zip 93306 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: n PROG A - HAZMAT ll, ~~ 0~ ld J~ Based on my inquiry of those individuals responsible for obtaining the information, I G®rtify under penalty of law that I have personally examined and am familiar with the Information submitted and believe the information is true, accurate, and ,ompiete. ~ 13 (olv Signatur Date ~~,o 5~1 ~~~ /U ~ l 4 240 6 -1- 05/30/2006 + CONFORT DENTAL FAMILY _______________________________ SitelD: 015-021-003011 + Manager SAEKYU OH, DMD Location: 2631 FASHION PLEA City BAKERSFIELD BusPhone: (661) 871-2223 Map 103 CommHaz High Grid: 22A FacUnits: 1 AOV: CommCode: BFD STA 08 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency C ntact / Title SAEKYU OH , DMD / OWN~`'R ~~C ~~- ~w-'rYGZ / /Yl ~ o. y e~- Business Phone: (661) 871-2223x Business Phone: (661) 871-2223x 24-Hour Phone (lo(ve) 871 - 22Z.~~+'+h 24-Hour Phone (~G/) &7/ - z2z 3x Answ ~'~ Pager Phone ( ) - x ~~^'~ Pager Phone ( ) - x . S~.i/! ~- Hazmat Hazards: Fire Press ImmHlth DelHlth Contact SAEKYU OH, DMD MailAddr: 2631 FASHION PL,~A City BAKERSFIELD Phone: (661) 871-2223x State: CA Zip 93306 Owner SAEKYU OH, DMD Address 2631 FASHION PLEA City BAKERSFIELD Phone: (661) 871-2223x State: CA Zip 93306 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: ENS ~~N O 9 ZDD6 Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, O accurate, and complete. ~~` ign ure Date -1- 12/21/2005 ~~ , COMFORT~DENTAL FAMILY ~~303 Manager ELIZABETH SERRANO Location: 2631 FASHION PL A City BAKERSFIELD CommCode: BFD STA 08 EPA Numb: SiteID: 015-021-003011 BusPhone: (661) 871-2223 Map 103 CommHaz High Grid: 22A FaCUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title SAEKYU OH DMD / OWNER ELIZABETH SERRANO / MANAGER Business Phone: (661) 871-2223x Business Phone: (661) 871-2223x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661) 600-2468x Pager Phone (661) 619-0421x Hazmat Hazards: Fire Press ImmHlth DelHltf~ Contact SAEKYU OH DMD Phone: . (661) 871-2223x MailAddr: 2631 FASHION PL A State: CA City BAKERSFIELD Zip 93306 _..... Owner SAEKYU OH DMD Phone: (661) 871-2223x Address 2631 FASHION PL A State: CA City BAKERSFIELD Zip 93306 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif~d: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~ l~~~O r' ~N~ M~~ ~ ~ ~~t~~ Based on my inquiry of those individuals responsible for obtaining the information, i certifiy under penalty of law that f have personally examined and am familiar with the information submitted and believe the information is true, accurate, nd complete. Sign ture Date -1- O1/29/2i)07 F COMFORT DENTAL FAMILY SiteID: 015-021-003011 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ ................ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit N~CP _ _ ... NITROUS OXIDE F P IH G 512.00 FT3 Hi OXYGEN F IH DH G 1004.00 FT3 Lbw HELIUM F P IH G 219.00 FT3 Ntn -2- O1/29/2b07 -3- O1/29/2b07 F COMFORT DENTAL FAMILY ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME NITROUS OXIDE Location within this Facility Unit GAS CLOSET STATE TYPE PRESSURE _ Gas Pure Above Ambient SiteID: 015-021-003011. ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 10024-97-2 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 256.00 FT3 512.00 FT3 512.00 FT3 riAGHtCLVUJ ~vinrvivl;ly 15 $Wt. RS CAS# 100.00 Nitrous Oxide No 10024972 t1HGE1KL H5~L' ~~1~1L" 1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# M No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit GAS CLOSET STATE TYPE PRESSURE _ Gas Pure Above Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER,,,,,,,,,,,,,, AMOUNTS AT THIS LOCATION Largest Co251100rFT3 Daily1004100m FT3 I Daily1004r00e FT3_ YlHGLiKLVU.7 LVP'lYVlVralV1D %Wt. RS CAS# 100.00 Oxygen, Compressed No 778247 ti1~GKKL H.7 .7L" .7J1~1L' 1V l TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MAP No No No No/ Curies F IH DH / / / Lnw -4- O1/29/2b07 F COMFORT DENTAL FAMILY ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit GAS CLOSET STATE TYPE PRESSURE _ Gas TPure ~-Above Ambient SiteID: 015-021-00301]. ~ Facility Unit: Fixed Containers at Site ~ ............. Days On Site 365 Map: Grid: CAS# 7440-59-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 219.00 FT3 219.00 FT3 219.00 FTC nt~~tucLUU~ ~ui~irulv~lvl~ oWt. RS CAS# 100.00 Helium No 744057 tiHGKKL A5.5L";~51~1L";1V"1'~i TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MSC No No No Noj Curies F P IH j / / Mii -5- O1/29/~b07 F COMFORT DENTAL FAMILY SiteID: 015-021-003011 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ nyGill.y 1VV1.1111..dL1V11 Employee Notif./Evacuation rW.J111: 1VV 1.11 ~ P.~VdI.:LLd1.1 Vi1 ~uicl_ycllt_:y 1.1CU11:d1 t'1di1 -6- Ol/29/2b07 F COMFORT DENTAL FAMILY SiteID: 015-021-003011 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Sits ~ xelease rrevenLion Release Containment ~ieaii up Other Resource Activation -7- O1/29/~b07 F COMFORT DENTAL FAMILY SiteID: 015-021-003011.E Fast Format ~ ~ Site Emergency Factors Overall Sites ~ .~Nc~,iai nac~atu~ - S r.Lic ric~~.~~:. ~t-wall. water ~ulruliiy vc:~upancy Level -8- O1/29/Z~07 P COMFORT DENTAL FAMILY SiteID: 015-021-003011 Fast Format ~ Training Overall Site ~ Employee Training rage Hera =or r~uLUre use neicz Lur r u~ure use -9- 9 01/29/2007 SaeKyuOh,D.M.D. D~~~Qo Comfort Dental Family 2631-A Fashion Place Bakersfield, CA 93306 661 871 ABCD ~ _-~ ~'~ a i UNIFIED PROGRAM INSPECTION CHECKLIST •~ t~lk4t~t!JNit-0l~~A~ ".X4 tdR4Ht4 SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 9330~jE~ ? 11QD~ Tel: (661_) 326-3979 ____ _ _ FACILITY NAME / ~ n ~ n, mare. ~ wrv ~ c murc~. ~ vn ~ imc K~`~~ IJ~'„"~ --- -----~ M------__--..._-- ___..__-___'n~'' ...__--- -.___. ___..._..____.._._ ._ ____._._._....._.. ._._. __. ..- --~'~-~ ~-- --------..._..._ - ADDRESS PHONE No. No. of Em to ees 2~~ i ~l~S~c«.3 Qt.J~e~ ~ ~ "~`~] --------------- ----..__...------ ___...--- - -.. --- ---....---------....- ----- .. _.__ ..~- -~-1-.. FACILITYCONTACT Business Number 15-021- I~/:=-=cam,) Section 1: Business Plan and inventory Program ~ ~ ~ ^ Routine ^ Combined ^ Joint Agency OMulti-Agency ^ Complaint Re-inspection C V (V=V o atonnCe~ OPERATION COMMENTS d' ^ ^ APPROPRIATE PERMIT ON HAND co __ ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ ~ VERIFICATION OF INVENTORY MATERIALS I (~C~J~y~1 N C~Z ^ ^ VERIFICATION OF QUANTITIES 2s I ~ tF ~~7_ X -Z Zt G ^ ^ .VERIFICATION OF LOCATION ~mP~~ ~~~cS ~~Sti~~ ^ ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITYE I~ ^ ^ ....- ----. ...___ VERIFICATION OF HAT MAT TRAINING ! f _..__.._... _..__... l _..._. _._ _.. ... _. _--.... _.._ - -..____._...... ~\ , ~ ~n h L LJI,/ 1L " ^ ^ VERIFICATION OF ABATEMENT SUPPLIES ANO PROCEDURES I ,~. . .__ ^ ^ EMERGENCY PROCEDURES ADEOUATE (~ ^ ^ CONTAINERS PROPERLY LABELED - ---- ^ ^ HOUSEKEEPING ^ ^. FIRE PROTECTION --- -----------. _...__.._ ....._...i ---- - -- - -- -- - - _ __..__..... ^ ^ SITE DIAGRAM ADEQUATE Sr ON HAND ANY HAZARDOUS WASTE ON SITE?: ~^,~.YIES ~ NO EXPLAIN: ~tCy~TlxL.- X-``r"`t' QUESTIONS REGARDING THIS INSPECTIOf+I~ PLEASE CALL US AT ~G6') ~ 326-3979 ' ,~ r f ir~~ - - ----...11 ~! ---------_ ._..------------ ----- ~ - - --- -------------... _._ __ _....- -...._ Inspector (Please Print) Fire Prevention t st-IMShift of Site White -Environmental Services Yellow -Station Copy ~ ~ ~ I e Site Responsible ease Print) Pink -Business Copy