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HomeMy WebLinkAboutBUSINESS PLANHOUCHIN BLOOD BANK SERVICES H 2600 G STREET int. ^" y -:~ + HOUCHIN COMMUNITY BLOOD BANK ________________________ SiteID: 015-021-000285 + Manager BusPhone: (661) 327-8541 Location: 2600 G ST Map 102 CommHaz Low City BAKERSFIELD Grid: 25B FacUnits: 1 AOV: CommCode: BFD STA O1 SIC Code: gp99 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title RANDY GREENLEE / SAFETY COORD GARY MILLER / FACILITY MAINT Business Phone: (661) 32'T-8541xii~7 Business Phone: (661) 323-4222x ZIP 24-Hour Phone (661) 873'-1065x 24-Hour Phone (661) 387-~8x 1567 Pager Phone (661) 3"~f0 -2~.37x Pager Phone (661) ..6~-8--43~~x +---------------------------------------+ ------------------ ----- 3~,~ ~$~-----+ Hazmat Hazards: Press ImmHlth Contact RANDY GREENLEE Phone: (661) 327-8541x17 MailAddr: 2600 G ST State: CA City BAKERSFIELD Zip 93301 Owner HOUCHIN COMMUN?~TY BLOOD BANK Phone: (661) 327-8541x Address 2600 G ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK ENT APIA ~ 1 2006 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, accurate, and complete. tur Date t_________________________-~--___________________________________________________+ -1- 02/27/2006 , n . ~ _ , HAZARDOUS MATERIALS MANAGEMENT PLAN ~ __ __ B E R S P I D SITE & FACILITY DIAGRAM FIA'E ARTN T Pglofl Bakersfield Fire Dept. Environmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 SITE DIAGRAM x FACILITY DIAGRAM Business Name: HOUCHIIV BLOC~- Business Address: ~~~~ Main Floor ~ Basement Protected By Automatic Sprinkler Systems A, B C, D, E, F =Electrical Breaker Boxes ~tJPC Deisel #2 Combustable Liquid w .- O s :. ~ .. •~:. Y ^ L C rm V A Water Shut Off o afGas Shut Off B Carbon Dioxide•Cl "~'~ Gi C B o~Fire Sprinkler Shut Off F Cesium+ 37 ox ~ Fire De artment Connection~A _ 2~th Street NORTH Fire hYd@indi atedirection fNorth Bakersfield Fire Dept. l9NIFIE® PROG~flA INSI~ECTI®N CHECMCLIST Enironmental Services - . ~ ~ ~ ~ 1.715 Chester Ave I SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 • Tel: (661)326-3979 FACILITY NAME -_~_©~ ADDRESS ~~~ FACILITYCONTACT ~- ~~~,e - ISPECTION DATE INSPECTION TIME ~ i1~6 rQ4-- ~.~ 15-021- a o Q 1~ u ,. . Section 1: Business Plan and Inventory Program ^ Routine D Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V \V=VioaPoinncel OPERATION COMMENTS i~' ^ APPROPRIATE JPERMIT ON HAND L~' ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE LN ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY LJ ^ ~ VERIFICATION OF INVENTORY MATERIALS ~ ^ VERIFICATION OF QUANTITIES Ud ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE ~ ^ VERIFICATION OF HAT MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ©' ^ CONTAINERS PROPERLY LABELED l~ ^ HOUSEKEEPING - -----------------_..-- -- -------- .-------T- - --- -._..----------- --- - --- ------ ------ l~ ^ FIRE PROTECTION ~ LK ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES IJ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~66~ ~ 326-3979 - --~-------- ---~ --~=----- ---------- ~---1--~------ - ---- -- tnspector (Please Print) Fire Prevention 1st-InlShift of Site White -Environmental Services Yellow -Station Copy Busi ss i espo 'ble Pa (Please Print) 8 N Pink -Business Copy \ 'f HOUCHIN COMMUNITY BLOOD BANK Manager GREG GALLION Location: 2600 G ST City BAKERSFIELD SiteID: 015-021-000285 BusPhone: (661) 327-8541 Map 102 CommHaz Extreme Grid: 25B FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: SIC Code:8099 DunnBrad: Emergency Contact / Title Emergency Contact / Title RANDY GREENLEE / SAFETY COORD GREG GALLION / CEO Business Phone: (661) 327-8541x117 Business Phone: (661) 323-4222x 24-Hour Phone (661) 873-1065x 24-Hour Phone ( ) - x Pager Phone (661) 340-2232x Pager Phone ( ) - x Hazmat Hazards: Press ImmHlth DelHlth Contact RANDY GREENLEE Phone: (661) 327-8541x117 MailAddr: 2600 G ST State: CA City BAKERSFIELD Zip 93301 Owner HOUCHIN COMMUNITY BLOOD BANK Phone: (661) 327-8541x Address 2600 G ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTS: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~~/~ PROG T - ABOVEGROUND S ~ TORAGE TANK ~/, ~ l ~ ~~ ~~ `` ~ =`~ c~; r~~y ir,gc;iry of those individuals respc~n;ible for obtaining the inform u d i n at on, !certify er Aenalty of !aw that I h ave personally. exam~rad and am familiar with the information submstTec, anti beli eve the information is true, accurate, and Complete. = ,.,,, Slg~ atur~ ~ - ~ ~ ~-~-~ Date -1- 07/12/2007 -2- 07/12/2007 F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ -3- 07/12/2007 F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CESIUM 137 Days On Site 365 Location within this Facility Unit Map: Grid: MANUFACTURING AREA CAS# 10045-97-3 STATE T TYPE ~(~ PRESSURE TEMPERATURE ~ CONTAINER TYPE Solid I Pure I Ambient ~ Ambient I METAL CONTAINR-NONDR~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1700.00 CUR 3400.00 CUR 3400.00 CUR HAZARDOUS COMPONENTS oWt. RS CAS# 100.00 Cesium No 10045973 t1E~GEi1CL H55~551~1J;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Ext ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME JPC DIESEL #2 Location within this Facility Unit STATE TYPE PRESSURE Liquid TMixture ~ Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 68476-34-6 TEMPERATURE CONTAINER TYPE Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5 0 0. 0 0 GAL - 5 0 0. 0 0 GAL 3SO .~-A~9-$8• GAL ruiuru~LV~a ~,vrirvlvr~l~tS oWt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 11t]L~L'].[<L ti. 7.7 L~.7.71"1LilV1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -4- 07/12/2007 1 F HOUCHIN COMMUNITY BLOOD BANK ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME CARBON DIOXIDE SOLID Location within this Facility Unit DISTRIBUTION AREA STATE TYPE PRESSURE _ Solid TPure ~-Above Ambient SiteID: 015-021-000285 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 124-38-9 TEMPERATURE CONTAINER TYPE Ambient BIN AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 200.00 LBS 200.00 LBS 100.00 LBS ~- r~~.ytcL~ua ~~i~ir~iv~iv l~~ oWt. RS CAS# 100.00 Carbon Dioxide No 124389 riAGHKL 1~Ji5JJl~lt'~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies P IH / / / Min -5- 07/12/2007 F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 02/28/2007 JPC DIESEL #2: MAINTENANCE DEPT INSPECTS TANK, TANK LINES, FILTERS AND GENERATOR-RELATED FUEL LINES WEEKLY. A BACK-UP TEST IS CONDUCTED EACH MONTH. CESIUM 137: OSL BADGES ARE WORN BY EMPLOYEES WORKING IN THE AREA CONTAINING THE CESIUM 137. THE AREA OF THE CESIUM 137 IS ALSO MONITORED BY OSL BADGES. AN ANNUAL MAINTENANCE PROGRAM IS PERFORMED BY THE MANUFACTURER OF THE CONTAINMENT DEVICE (IBL-437 BLOOD IRRADIATOR). SEMI-ANNUAL LEAK (WIPE) TESTS AND ENVIRONMENTAL SURVEYS ARE PERFORMED BY HOUCHIN PERSONNEL. 9 Employee Notif./Evacuation 02/28/2007 JPC DIESEL #2: THE FOLLOWING INDIVIDUALS WILL BE NOTIFIED: RANDY GREENLEE OR GREG GALLION. THEY WILL CONTACT THE OFFICE OF EMERGENCY SERVICES 800-852-7550 AND/OR THE OFFICES OF ENVIRONMENTAL SERVICES, CITY OF BAKERSFIELD AT 326-3979. CESIUM 137: RANDY GREENLEE (RSO) OR PAT GLARY (ARSO) ARE TO BE CONTACTED IN THE EVENT THAT A LEAK IS DETECTED. AS WELL AS OES, THE NUCLEAR REGULATORY COMMISSION OPERATIONS CENTER 301-816-5100 IS TO BE NOTIFIED. Public Notif./Evacuation 09/28/2006 THE PERSON OR PERSONS FINDING AN ENVIRONMENTAL SPILL ARE REQUIRED TO NOTIFY 911. THEN WILL BE RESPONSIBLE TO CONTACT APPROPRIATE CLEAN-UP COMPANY AND WILL INSTRUCT PERSONNEL TO NOTIFY THE APPROPRIATE AUTHORITIES. Emergency Medical Plan 09/28/2006 EMPLOYEES ARE INSTRUCTED TO CONTACT SAN JOAQUIN HOSPITAL, 2615 EYE ST, 395-3000. THIS IS AS PER OUR MEDICAL EMERGENCY POLICY. -6- 07/12/2007 F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 04/11/2006 JPC DIESEL #2: OUR TANK IS MANUFACTURED BY TIGER TANKS AND IS DOUBLE-WALL STEEL WITH GRANULAR FILL BETWEEN WALLS. ALL TANKS ARE FIRE RATED AND TESTED BY UNDERWRITERS LAB IN NORTHBROOK, IL. ALL TANKS ARE ALSO BALLISTIC RATED AND APPROVED BY THE CALIFORNIA AIR RESOURCES BOARD. CESIUM 137: THE IBL 437C IS A SELF-SHIELDED IRRADICATOR WITH 9 INCHES OF LEAD SHIELDING. MANUFACTURER: CIS-US INC. WEIGHT: 4600 LBS 9 Release Containment 02/28/2007 THE TANK IS A GRANULAR-FILLED TANK. IF TANK IS COMPROMISED THE GRANULAR FILL WILL SOAK UP SOME OF THE SPILL. EMPLOYEES ARE INSTRUCTED TO CALL GREG GALLION OR RANDY GREENLEE IF A SMALL LEAK IS NOTICED SO THAT WE CAN DETERMINE THE COURSE OF ACTION TO CORRECT THE LEAK. EMPLOYEES ARE INSTRUCTED, AS PER OUR HAZARD COMMUNICATION POLICY, TO CALL 911 IF A LARGER SPILL OR LEAK IS NOTICED THEN CALL GREG GALLION OR RANDY GREENLEE. Clean Up 04/11/2006 IF A LEAK OR SPILL IS NOTICED ALL SAFETY PROCEDURES INDICATED BY THE MOST CURRENT MSDS WILL BE FOLLOWED. IF SPILL OR LEAK CANNOT BE CONTAINED BY EMPLOYEES A THIRD PARTY SPECIALIZING IN HAZ WASTE REMOVAL AND CLEAN-UP WILL BE CONTACTED. Other Resource Activation -7- 07/12/2007 F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ 5peciai nazarus Utility Shut-Offs 02/28/2007 GAS - R OF NE EXIT/ENTR ELECTRICAL - rT•T TATTT T TTTTT Tr1n TTT_~] WATER - R OF NE EXIT/ENTR KNOX BOX - OUTSIQQDE /IMAIN ENTR f /, ,-,• ~- A,w1 p~tG~(~ ~ ~1pt~u/ °-- ~ W ~~ 7.Ut ~.2~V W~~~ b) ~( ~> raw ~~~~ Fire Protec./Avail. Water 02/28/2007 PRIVATE FIRE PROTECTION - FIRE SPRINKLERS AND 7 CO2 EXTINGUISHERS. FIRE HYDRANT - ACROSS ST SE SIDE OF BLDG ON 26TH ST. Building Occupancy Level 65 EMPLOYEES 02/28/2007 -8- 07/12/2007 ., F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 09/28/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE REQUIRED TO RECEIVE HAZARD COMMUNICATION, BIOHAZARD, AND HAZ WASTE TRAINING AT THE TIME OF EMPLOYMENT. THIS TRAINING IS REVIEWED WITH EMPLOYEES ON A YEARLY BASIS. CESIUM 137: ALL EMPLOYEES ARE GIVEN BASIC SAFETY AND FAMILIARIZATION TRAINING IN REGARDS TO THE IBL-437. OPERATORS OF THE DEVICE ARE GIVEN ANNUAL REFRESHER TRAINING. rayc ~ izc.~u ivi ru~.uic ~~c nciu ivi ru~uic ~5c -9- 07/12/2007 AZARDOUS MATERIALS MANAGEMENT PLAN B B R S F I D SITE & FACILITY DIAGRAM P/RE ARIA/ T Pg 1 of 1 Bakersfield Fire Dept. Environmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 SITE DIAGRAM ~( FACILITY DIAGRAM Business Name: H~UCHIN BL~J~Q SERVICES ~R~UND LEVEL Business Address: ~~~~ ~ STREET BAKERSFIELD CALIFI~RNIA 93~3~'I Main Floor 8 Basement Protected By Automatic Sprinkler Systems A, B C, D, E, F =Electrical Breaker Boxes ~~JPC Deisel #2 Combustible Liquid O ~ :. ~ .. .. ~ ~'~:. m C N ~ A Water Shut Off o a~Gas Shut Off B Carbon Dioxide•C] "~"~ oFFire Sprinkler Shut Off F Cesium-137 OCi C D Ba Fire De artment GonnectioMs 2~th treat NORTH Fire Hyda~~indi ate direction fNorth ' ~ HAZARDOUS MATERIALS MANAGEMENT PLAN B B R S P I D SITE ~ FACILITY DIAGRAM PIKE ART~I T Pglofl Bakersfield Fire Dept. Environmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 SITE DIAGRAM ~( FACILITY DIAGRAM Business Name: HUUCHIN BLi]~D SERVICES BASrEiIdIENT Business Address: ~~~ ~ STREET BAKERSFIELQ C~4LIFORNIA 933~'I Main Floar 8 Basement Protected By Automatic Sprinkler Systems A, B C, D, E, F =Electrical Breaker Baxes +JPC Deisel #2 Combustable Liquid Main Switchboard E Water Shut Off + o oFGas Shut Off ~~Fire Sprinkler Shut Off Fire De artment Connection+~ ~p V 2~th Strut NORTH FireHyd~~ind~ ate direction of North J`tye~-. ~'~~ CITY OF BAKERSFlE1.D FIRE DEPARTMENT '~~ ~ OFFICE OF ENVIRONMENTAL SERVICES ~' ~ UNIFIED PROGRAM INSPECTION CHECKLIST `w i~ I715 Chester Ave., 3rd Fioor, Bakersfield, CA 93301 FACILITY NAME ~7U~'~-~t~` ~^^"'t - ~'~t'~ INSPECTION DATE (U,17~~3 _ ADDRESS- ~.C-c~O ~U S~ • PHONE NO•_ '32-7 ~ `~/ FACILITY CONTACT ~,2-I - 43 Sys BUSINESS ID NO. l 5-21 U- INSPECTION TIME 1 C~ ~ ~s ~~ ~,~ NLIMBER OF EMPLOYEES Section l: Routine Business Plan and Inventory Program ^ Combined ^ Joint Agency ^Molti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand G Business plan contact information accurate Visible address C. Correct occupancy ~. Verification of inventory materials C Verification of quantities Verification of location (;SJ Nl~? ~r--~er i hlWr Proper segregation of material C Verification of MSDS availability C Verification of Haz Mat training Verification of abatement supplies and procedures C Emergency procedures adequate Containers properly labeled C. Housekeeping Fire Protection G Site Diagram Adequate & On Hand C C=Compliance V=Violation .~~~ / Any haiardous waste on site?: ^ Yes ~ No ` '~" `~`-iJ'~ Explain: ~ :~ J Questions regarding this inspection? Please ca{I us at (661) 326-3979 Business Site Res onsible Patty Whitr -Env. Svcs. Yellow -Station Copy Pink -Business Copy Inspector: ~ U!'t~ T 7 ~~ :Zi HOUCHIN COMMUNITY BLOOD BANK Manager :~~c1(~Q'llic~n .- CEO Location: \2600 G ST City BAKERSFIELD SiteID: 015-021-000285 BusPhone: (661) 327-8541 Map 102 CommHaz Extreme Grid: 25B FacUnits: 1 AOV: CommCode: BFD STA Ol SIC Code:8099 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title RANDY GRE ENLEE / SAFETY COORD / TT nTT Tr*+.• *R~ r~.tm Business Phone: (661) 327-8541x117 Business Phone: (661) 323-4222x~2t0 24-Hour Phone (661) 873-1065x 24-Hour Phone (661) 387 15-~x Pager Phone (661) 340-2232x Pager Phone (661) ?~-~- ~~Tx Hazmat Hazards: Press ImmHlth DelHlth Contact RANDY GREENLEE Phone: (661) 327-8541x117 MailAddr: 2600 G ST State: CA City BAKERSFIELD Zip 93301 Owner HOUCHIN COMMUNITY BLOOD BANK Phone: (661) 327-8541x Address 2600 G ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK ~Nr'p ~~~ 2 ~ goo 7 Eased 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 , accurate, and complete. ~' '~~ "©~ Si atu Date -1- 02/01/2007 •. • Y F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP CESIUM 137 DH S 3400.00 CUR Ext JPC DIESEL #2 L 500.00 GAL Low CARBON DIOXIDE SOLID P IH S 200.00 LBS Min -2- 02/01/2007 -3- 02/01/2007 a F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CESIUM 137 Days On Site 365 Location within this Facility Unit Map: Grid: MANUFACTURING AREA CAS# 10045-97-3 ~SolidE I PureE ~~~ PRESSURE TEMPERATURE CONTAINER TYPE I Ambient ~ Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I-- Daily Average 1700.00 CUR 3400.00 CUR 3400.00 CUR t1HGH.KLVU~ lLV1~lYV1VJ;1V1J %Wt. RS CAS# 100.00 Cesium No 10045973 t11~GL~ttL HJ~J;JJ1~1L'1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Ext ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME JPC DIESEL #2 Location within this Facility Unit STATE TYPE PRESSURE Liquid TMixtur=mbient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 68476-34-6 TEMPERATURE CONTAINER TYPE Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 500.00 GAL 500.00 GAL 500.00 GAL 1'1HGKCCLVU~7 1.V1~lYV1V~1V 1.7 oWt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 t1EiGF~tCL F~i.7.7L" .7~l~lt'ilV 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -4- 02/01/2007 F 1. , F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CARBON DIOXIDE SOLID Days On Site 365 Location within this Facility Unit Map: Grid: DISTRIBUTION AREA CAS# 124-38-9 ~SolATdE T TYPE T~oveSAmbEent I AmbientTURE ~ CONTAINER TYPE Pure I I BIN AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 LBS 200.00 LBS 100.00 LBS rlr~~.ytc,uvu5 wlnrc~iv~;lv~t~5 %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 t1HGHKL A~ >w`SL"i~~P/1L"-1V"1"5 TSecret RS BioHaz Radioactive/Amount EPA .Hazards NFPA USDOT# MCP No No No No/ Curies P IH / / / Min -5- 02/01/2007 ', F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 04/11/2006 JPC DIESEL #2: MAINTENANCE DEPT INSPECTS TANK, TANK LINES, FILTERS AND GENERATOR-RELATED FUEL LINES WEEKLY. ABACK-UP TEST IS CONDUCTED EACH MONTH. os~ O5L CESIUM 137: -9~F-i BADGES ARE WORN BY EMPLOYEES WORKING IN THE AREA~ONTAINING THE CESIUM 137. THE AREA OF THE CESIUM 137 IS ALSO MONITORED BY-6B~~ BADGES. AN ANNUAL MAINTENANCE PROGRAM IS PERFORMED BY THE MANUFACTURER OF THE CONTAINMENT DEVICE (IBL-437 BLOOD IRRADIATOR). SEMI-ANNUAL LEAK (WIPE) TESTS AND ENVIRONMENTAL SURVEYS ARE PERFORMED BY HOUCHIN PERSONNEL. 9 = Employee Notif./Evacuation 04/11/2006 ~ Ga11~vn JPC~ESEL #2: THE FOLLOWING INDIVIDUALS WILL BE NOTIFIED: RANDY GREENLEE OR THEY WILL CONTACT THE OFFICE OF EMERGENCY SERVICES 800-852-7550 AND/OR THE OFFICES OF ENVIRONMENTAL SERVICES, CITY OF BAKERSFIELD AT 326-3979. Ra.r,dy Gr~~~le~ CESIUM 137: - (RSO) OR PAT GLARY (ARSO) ARE TO BE CONTACTED IN THE EVENT THAT A LEAK IS DETECTED. AS WELL AS OES, THE NUCLEAR REGULATORY COMMISSION OPERATIONS CENTER 301-816-5100 IS TO BE NOTIFIED. Public Notif./Evacuation 09/28/2006 THE PERSON OR PERSONS FINDING AN ENVIRONMENTAL.SPILL ARE REQUIRED TO NOTIFY 911. THEN WILL BE RESPONSIBLE TO CONTACT APPROPRIATE CLEAN-UP COMPANY AND WILL INSTRUCT PERSONNEL TO NOTIFY THE APPROPRIATE AUTHORITIES. Emergency Medical Plan 09/28/2006 EMPLOYEES ARE INSTRUCTED TO CONTACT SAN JOAQUIN HOSPITAL, 2615 EYE ST, 395-3000. THIS IS AS PER OUR MEDICAL EMERGENCY POLICY. -6- 02/01/2007 n ` F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/11/2006 ~ JPC DIESEL #2: OUR TANK IS MANUFACTURED BY TIGER TANKS AND IS DOUBLE-WALL STEEL WITH GRANULAR FILL BETWEEN WALLS. ALL TANKS ARE FIRE RATED AND TESTED BY UNDERWRITERS LAB IN NORTHBROOK, IL. ALL TANKS ARE ALSO BALLISTIC RATED AND APPROVED BY THE CALIFORNIA AIR RESOURCES BOARD. CESIUM 137: THE IBL 437C IS A SELF-SHIELDED IRRADICATOR WITH 9 INCHES OF LEAD SHIELDING. MANUFACTURER: CIS-US INC. WEIGHT: -4600 LBS Release Containment 04/11/2006 THE TANK IS A GRANULAR-FILLED TANK. IF TANK IS COMPROMISED THE GRANULAR FILL WILL SOAK UP SOME OF THE SPILL. EMPLOYEES ARE INSTRUCTED TO CALL P~L-r~R OR RANDY GREENLEE IF A SMALL LEAK IS NOTICED SO THAT WE CAN DETERMINE THE COURSE OF ACTION TO CORRECT THE LEAK. EMPLOYEES ARE INSTRUCTED, AS PER OUR HAZARD COMMUNICATION POLICY, TO CALL 911 IF A LARGER SPILL OR LEAK IS NOTICED THEN CALL OR RANDY GREENLEE. ~R~ q ~Q,l ~c3n Clean Up 04/11/2006 IF A LEAK OR SPILL IS NOTICED ALL SAFETY PROCEDURES INDICATED BY THE MOST CURRENT MSDS WILL BE FOLLOWED. IF SPILL OR LEAK CANNOT BE CONTAINED BY EMPLOYEES A THIRD PARTY SPECIALIZING IN HAZ WASTE REMOVAL AND CLEAN-UP WILL BE CONTACTED. Other Resource Activation -7- 02/01/2007 n ~, .. F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .~Nc~.iai azac~atu~ Utility Shut-Offs 02/01/2007 A) GAS - R OF NE EXIT/ENTR B) ELECTRICAL - SW WALL JANITORIAL RM C) WATER - R OF NE EXIT/ENTR D) SPECIAL - NONE E) LOCK BOX - NO `Kt~tC~C t~ .~ e~~, ,~.vw.~. a.wJtn~-.~.~,r,:. , Fire Protec./Avail. Water 02/01/2007 1 PRIVATE FIRE PROTECTION - FIRE SPRINKLERS AND f~ CO2 EXTINGUISHERS. FIRE HYDRANT - ACROSS ST SE SIDE OF BLDG ON 26TH ST. Building Occupancy Level 02/27/2006 65 &(~ EMPLOYEES -8- 02/01/2007 1 a r F HOUCHIN COMMUNITY BLOOD BANK SiteID: 015-021-000285 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training .09/28/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUNIlKARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE REQUIRED TO RECEIVE HAZARD COMMUNICATION, BIOHAZARD, AND HAZ WASTE TRAINING AT THE TIME OF EMPLOYMENT. THIS TRAINING IS REVIEWED WITH EMPLOYEES ON A YEARLY BASIS. CESIUM 137: ALL EMPLOYEES ARE GIVEN BASIC SAFETY AND FAMILIARIZATION TRAINING IN REGARDS TO THE IBL-437. OPERATORS OF THE DEVICE ARE GIVEN ANNUAL REFRESHER TRAINING. rclye ~ Held for Future Use raciu i.vi ru~.utc vac -9- 02/01/2007 . HAZARDOUS MATERIALS MANAGEMENT PLAN a B R S F, D SITE & FACILITY DIAGRAM F/RE ART/1 T Pglofl Bakersfield Fire Dept. Environmental Services 1? 15 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 SITE DIAGRAM ~ FACILITY DIAGRAM BusinesslVame: HOUCHIN BLOOD SERVICES GROUNQ LEVEL Business Address: ~~~~ ~ STREET BAKERSFIELD CALIFORNIA 93~~"I Main Flaor 8 Basement Protected By Automatic Sprinkler Systems A, B C, D, E, F =Electrical Breaker Boxes +JPC Deisel #2 Combustable Liquid O t :. ~ .. .. .. ~~ a~ C 6Y A 1Nater Shut Off +o o+Gas Shut Off B I Carbon Dioxide~^ L ~"~ r ~+Fire Sprinkler Shut Off OC-- C D F Cesium-137 Bo Fire De artment ConnectioM~ ~p V ~, 2Gth ~tre~t NORTH Fire Hy~i4ndi tedirection fNorth AZARDOUS MATERIALS MANAGEMENT PLAN B e R s F, o SITE & FACILITY DIAGRAM F/RE Ali<TM T Pglofl Bakersfield Fire Dept. Environmeatal Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 SITE DIAGRAM ~( FACILITY DIAGRAM Business Name: H~UHIN BL~~]D SERVICES BA' SEMENT Business Address: ~~~~ ~ STREET BAI'CERSFIELD C14LIFt7RNIA 93~~'I Main Floor 8 Basement Protected By Automatic Sprinkler Systems A, B C, Q, E, F =Electrical Breaker Boxes ~~JPC l7eisel #2 Combustable Liquid Main Switchboard E Water Shut Off ~ o o~Gas Shut Off '*'~ ~~-Fire Sprinkler Shut Off Fire De artment Cannection~~ ~p V 2th street NORTH Fire Hy~lrgndi tedirection fNorth UNIFIED PROGRAM INSPECTION CHECKLIST ~ prevention services >3 e R s F i , D 900'IYuxtun Ave., Suite 210 FIRE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ~Rr~ Tel.: (661) 326-3979 - T rax: ~neii Asia-~i i i FACI L IT Y NAME INSPECTION DATE INSPECTION TIME 1 ~~ ] // /'~~~ ADDRESS PH NE NO. NO OF EMPLOYEES ~ (6 FACILITY CONTAC BUSINESS ID NUMBER ~ ~ ~ a 15-021- ~S5 ~ ire~ i,e Section 1: Business Plan and Inventory Program t -~ ~ _ - _ e„ _ __ _ __ _ ~e. LU~ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS l~ ^ APPROPRIATE PERMIT ON HAND L'7 ^ BUSIft@SS PLAN CONTACT INFORMATION ACCURATE ~IY iV ®~^ VISIBLE ADDRESS LzY~^ CORRECT OCCUPANCY C~' ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES Cid' ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ,~ / (]d' ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING L~^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 2 ~•G~2ti n°i ~ ' ~ / Inspector (PI ase Print) Fire Prevention / 1" In /Shift of Site/Station # `f ^ YES EEO White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05