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HomeMy WebLinkAboutBUSINESS PLAN 1/29/2007~~ ~~ ~' f~ i I~ A i', ~', LEONARDA S ALEXANDER ~~ ~, 2611 G STREET ,~ ALEXANDER DDS LEONARDA S Manager : ~,1(1Gl ~Z~nsec~ Location: 2611 G ST City BAKERSFIELD SiteID: 015-021-002301 BusPhone: (661) 859-0192 Map 102 CommHaz Minimal Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact /. Title S ~ " Emergency Contact / Title A• D• C LEONARDA ALEXANDER / .y~IS / Business Phone: (661) 859-0192x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661) 330-6563x Pager Phone ( ) - x Hazmat Hazards: React Contact LEONARDA S ALEXANDEER Phone: (661) 859-0192x MailAddr: 2611 G ST State: CA City BAKERSFIELD 'Zip 93301 Owner LEONARDA S ALEXANDEER Phone: (661) 859-0192x Address 2611 G 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 ~ ~~-~~~5 ENj Based on my inquiry of those Indl~ldbals responsible for obt i i h ~ ~. ~~ Z r n a ng t e Inform~ttlon, I certify under penalty of law that I have personally ' ZQO examined and am familiar with the information , submitted and believe the information is true , accur and complete. a ~" / V~ Si n re D e -1- 01/24/2007 F T F ALEXANDER DDS LEONARDA S SiteID: 015-021-002301 ~ ~ 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 2.00 GAL Min -2- 01/24/2007 -3- 01/24/2007 ti F ALEXANDER DDS LEONARDA S ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit SUPPLY CLOSET SiteID: 015-021-002301 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 2.00 GAL 2.00 GAL 2.00 GAL ru~~t~tcLC~uS ~:vinr~lv~ivl~ °sWt. RS CAS# Silver No 7440224 til'~GEiKL A~J~JJ1~11'~1Vla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 01/24/2007 F~ F ALEXANDER DDS LEONARDA S SiteID: 015-021-002301 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ r~yC11C:y 1VU1.1l1Cdl.lUil ~ulNl.vyca 1VU1.11. / ~VdCUdl.lUil ruirii~. 1vv1..11 / ~,Vdc,LLdl.lUil L~LIICiyCilCy 1~leQ1Cd1 rlan -5- 01/24/2007 F ALEXANDER DDS LEONARDA S SiteID: 015-021-002301 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ 1CC1Cd~C rLCVCll l,lV11 Y 1CC ICQSC 1rV111.d111llLCll 1. L.1 Cdll V~J V l.ilCL tCCSVUL C:C L"~C: l.1VaL 1OI1 -6- 01/24/2007 F ALEXANDER DDS LEONARDA S SiteID: 015-021-002301 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ a7~lC l.:1 CL1 na~aiu~ Utility Shut-Offs ,. i•iic rtv~.ct~.~l-~vaii. vva~.ci ~ ~ ~ _ ~ 1~u11ullly vv~.uNall~..y Lc V G1 ' -7- 01/24/2007 .i? ;r. F ALEXANDER DDS LEONARDA S SiteID: 015-021-002301 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training rayc c. nciu iui. ru~uic vac nc.~.u tut r u~.utc uac -8- 01/24/2007 .1= ,~. -~ ~ 3a~~C UNIFI ~ D PROGRAM INSPECTION CHECKLIST ~ SECTION -1: Business Plan and Inventory Program ~:.~. H A'_~'~~E R_S F._l n `' '' FIRE ARTM T ~. Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~I.E~An,p~l1, ~~S ~ INSPECTION D ` TE o INSPECTION TIME ADDRESS ~~ ~' "' ~ ° ~ ~ } - - PHOQN NQO.' as ~ 015L NO OF E OYEES -.~ FACILITY CONTACT _ -. BUSINESS ID NUMBER 15-021- Ol S - ©21 ~a ^ 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 ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ 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 ~. (~ t G.I~~[ i to y~,11~1,or ~ q„V l ~ o y ~~+f ~! G ~ vV ~1 ^ SITE DIAGRAM ADEQUATE & ON HAND ~~ ANY HAZARDOUS WASTE N SITE?nn ~E~ YES ^ NO EXPLAIN: ~~~~- ~~+~ ~.K-. QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 G~v~~^^s Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # Bu ' e s it I onsible Party (Please Print) White -Prevention Services - Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ~` - r- . ~._ ~• _~~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME ~~ g~ °` ~ e ^ ~~ S Section 4: Hazardous Waste Generator Program ^ Routine l~ Combined ^ Joint Agency INSPECTION DATE y ~ ~ ~ EPA ID # ~~ C *~ ~= ~" ^ Multi-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~~, ~'~- 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 fine ~ Secondary containment provided Q.L ,. e ~, t.c~-~~7 (~;,,.~~, - Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste ~J Proper management of lead acid batteries including labels lV Proper management of used oil filters N ~ Transports hazazdous waste with completed manifest Sends manifest copies to DTSC S~~- t ~1 ~ Retains manifests for 3 years Retains hazazdous waste analysis for 3 years Retains copies of used oil receipts for 3 yeazs ~ Determines if waste is restricted from land disposal ~,=~.ompuance v=vto~aaon Inspector: ~ ~~~,--- Office of Environmental Services (661) 326-3979 White -Env. Svcs. Pink -Business Copy ur > L~~.- Busin Site Responsible Party ALEXANDER DDS LEONARDA S Manager LINA FONSECA Location: 2611 G ST City -: BAKERSFIELD SiteID: 015-021-002301 BusPhone: (661} 859-0192 Map 102 CommHaz Minimal Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title LEONARDA ALEXANDER / OWNER / Business Phone: (661) 859-0192x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661) 330-6563x Pager Phone ( ) - x Hazmat Hazards: ^~ React Contact LEONARDA S ALEXANDER Phone: (661) 859-0192x MailAddr: 2611 G ST State: CA City BAKERSFIELD Zip 93301 Owner LEONARDA S ALEXANDER DDS Phone: (661) 859-0192x Address 2611 G 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 aged on my ir.cfuiry of tho^^ indivi~'~~-.`~ ~+{~~~4J ~~~ ~ ~~~7 resp~.nsible for obtaining the information, I evrtifY 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. ~~U °~'~ S' nature Date l ~'~~ ~~ - v '. ~~ .. . .. - g ~~ - : - -. -1- l0/0l/200 i _.~_.~ F ALEXANDER DDS LEONARDA S SiteID: 015-021-002301 ~ ~ 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 2.00 GAL Min -2- 10/01/2007