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HomeMy WebLinkAboutBUSINESS PLANS 7/17/2007 •~~ . , ,-. :~, SANDOVAL DDS ROGER E SiteID: 015-021-002310 Manager Location: 1030 H ST 1 City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: BusPhone: (661) 323-9421 Map 103 CommHaz Minimal Grid: 31A FacUnits: 1 AOV: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title ROGER E SANDOVAL / DDS / Business Phone: (661) 323-9421x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact ROGER E SANDOVAL Phone: (661) 323-9421x MailAddr: 1030 H ST 1 State: CA City BAKERSFIELD Zip 93304 Owner ROGER E SANDOVAL Phone: (661) 323-9421x Address 1030 H ST 1 State: CA City BAKERSFIELD Zip 93304 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 respor;siblc: for olrta~nin tin i g e nformation, I certify under penalter of la~~• that I have personall ex y amined and am farniiiar uvith the information submitted and ±?f'lir' ve the information is true, . accurate, and complete. ~~ t `~ u C 7-/~-0 7 Signature Date ~~L 19 2007 -1- 0~/16/200~ _. u ~' ROGER E. SANDOVAL, DDS 1030 H STREET, SUITE 1 _I~~` ~ :~ ~ ~~ ~ ~ ~ Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST 9 f F R,s r , n 90o Truxtun Ave.; suite 210 ~~ Fief ~ Bakersfield, CA 93301 SECTION 1: Business Plan and.lnventory Program '~~~^1^--eT~~"'~~ ~ Tel•: (661) 3a6-39z9 ' - `~~ Fax: (661) 872-2171 FACILITY NAME ' ~A ~~J ~ INSPECjION D TE ~ 07 ~' INSPECTION TIME n) Q~~AL. / tg ADDRESS ~• /~ PHON N PLOYEES NO OFE ~ ~ ~ ~ ~ ~ !72/ B % FACILITY CONTACT ER BUSINESS ID NUM 15-021-Q•tS- ott.. ao Section 1: Business Plan and Inventory Program --. _ _ ~ - _ _- --Y ^ ROUTINE I~ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance- OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ~J ^ VERIFICATION OF MSDS AVAILABILITY ~ a ^ ^ VERIFICATION OF HAZ MAT TRAINING • •`, ~~ ~~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES 00~ ^ EMERGENCY PROCEDURES ADEQUATE ~L ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING - ^~~ FIRE PROTECTION ~~C~~ C¢. S~ ~~~ ~ rC ~~-~-~ ^ ~, . ~,~ -~ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ~~YES ^ NO EXPLAIN: ~ 01 S~C ~~ k Q a QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 G ~U:2~ I >~t Inspector (Please Print) Fire Prevention / 1s' In /Shift of Site/Station # L3 to r Busin Sit / esponsib a Party (Please Print) White -Prevention Services ~ Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 .n- - ~ - ~4~` ~~ e c b~ ~~ ~~ % P: as~~~i FACILITY NAME ~A~ D©~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES gJNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 ~ ~ 1^ ~ ~-S INSPECTION DATE ~ Section 4: Hazardous Waste Generator Program ^ Routine ~3 Combined ^ Joint Agency EPA ID # LX, ~ %^-~T ^ Multi-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~ 1C £ ;.~. ~ -~- 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 Q. Secondary containment provided ~ ~,,,, ,~ ~ ,Sa t:s~~ ~~'' l~ 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 Sends manifest copies to DTSC ~A?~~~~~ ~ G.~,'T~bL Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years ~l,$ Determines if waste is restricted from land disposal ~,=~,ompuance v=v~otanon Inspector: G ~U~IiIL ~ ~-- ~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. Pink -Business Copy Business Site Responsible Party ~ ,.,,.tea F SANDOVAL DDS ROGER E SiteID: 015-021-002310 ~ ~ 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- 07/16/2007 ~: -3- 07/16/2007 ~., ~ F SANDOVAL DDS ROGER E SiteID: 015-021-002310 ~ ~ 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 ~LASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL • nt~~rircLVU~ wlnrvlv~iv1~ ~Wt. RS CAS# Silver No 7440224 t1HGE1ttL A7~La~1~11;1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/16/2007 ~~ ~. F SANDOVAL DDS ROGER E SitelD: 015-021-002310 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/18/2007 ~ 911 Employee Notif./Evacuation VERBAL NOTIFICATION. EVACUATE THROUGH FRONT OR BACK DOORS. 04/18/2007 Public Notif./Evacuation VERBAL NOTIFICATION. EVACUATION THROUGH FRONT OR BACK DOORS. 04/18/2007 Emergency Medical Plan 04/18/2007 911 -5- 07/16/2007 y _~ F SANDOVAL DDS ROGER E SiteID: 015-021-002310 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/18/2007 ~ SECONDARY CONTAINMENT Release Containment 04/18/2007 SECONDARY CONTAINMENT Clean Up 04/18/2007 PAPER TOWELS OR ABSORBANT Other Resource Activation -6- 07/16/2007 ~, F SANDOVAL DDS ROGER E SiteID: 015-021-002310 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _, ,_ .~Nc~.iai nac~aiu~ Utility Shut-Offs GAS: E SIDE OF BLDG ELECTRICAL: E SIDE OF BLDG TnTATER: E SIDE OF BLDG 04/18/2007 Fire Protec./Avail. Water 04/18/2007 FIRE EXTINGUISHERS FIRE HYDRANT: H ST Building Occupancy Level 04/18/2007 11 EMPLOYEES -7- 07/16/2007 ~ ~ YT F SANDOVAL DDS ROGER E SiteID: 015-021-002310 ~ Fast Format ~ ~ Training Overall Site ~ P~lll~J1V1/CC 1L C1.111111y rayC ~ nclu LvL r ul.uLC vac Held for Future Use -8- 07/16/2007