HomeMy WebLinkAboutBUSINESS PLAN~~ ~, ;~ GARY KNERR, DDS
~~ `-' ~ 2613 G STREET
- - - _.__ ~
~.
KNERR DDS GARY SiteID: 015-021-002300
Manager GARY KNERR
Location: 2613 G ST
City BAKERSFIELD
CommCode: BFD STA Ol
EPA Numb:
BusPhone: (661) 322-1948
Map 102 CommHaz Minimal
Grid: 24D FacUnits: 1 AOV:
SIC Code:8021
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
GARY KNERR DDS / OWNER /
Business Phone: (661) 322-1948x Business Phone: ( ) - x
24-Hour Phone ( ) - x 24-Hour Phone ( ) - x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: React
Contact GARY KNERR Phone: (661) 322-1948x
MailAddr: 2613 G ST State: CA
City BAKERSFIELD Zip 93301
Owner GARY KNERR DDS Phone: (661) 322-1948x
Address 2613 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 ~~~Y
'd t'
U ~
~
4l z~o~
F~asecl or, my inquiry of those individuals
respnr;sii:le i~'?r eita~~,inq the information, !certify
_ under penalty of la~=1 t!-at I have personally
examined anci am fam~'~ar u:+ith the information
sut~mitt d anc~ ti~lia~~~ the information is true,
accur= ~ ,and r ,r ete.
- ry
Signature ~~~~`~ s p
( ~ a/
ate
-1- 07/12/2007
F KNERR DDS GARY
~ Hazmat Inventory =
~ MCP+DailyMax Order
= SiteID: 015-021-002300 ~
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- 07/12/2007
F KNERR DDS GARY
~ Inventory Item 0001
COMMON NAME / CHEMICAL NAME
WASTE FIXER
Location within this Facility Unit
UTILITY RM
STATE TYPE PRESSURE
Liquid TWaste ~ Ambient
SitelD: 015-021-002300 ~
Facility Unit: Fixed Containers at Site ~
Days On Site
365
Map: Grid:
CAS#
TEMPERATURE CONTAINER TYPE
Ambient ~ PLASTIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
t1AG1iK1JVU~ C:V1~lYVNl"~1V'1'~
- %VWt . . - -. - _ -- - ~ - _ - - - - -. RS - - CAS #
Silver No 7440224
ri1~GLitCL HJ 71'~ ~ 71~11"~1V 1 J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies R / / / Min
-4- 07/12/2007
F KNERR DDS GARY SiteID: 015-021-002300 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site ~
~ Agency Notification 04/19/2007 ~
911
= Employee Notif./Evacuation 04/19/2007
VERBAL NOTIFICATION AND EXIT THROUGH FRONT OR SIDE DOORS.
Public Notif./Evacuation 04/19/2007
VERBAL NOTIFICATION AND EXIT THROUGH FRONT OR SIDE DOORS.
Emergency Medical Plan 04/19/2007
TRANSPORT TO HOSPITAL
-5- 07/12/2007
F KNERR DDS GARY SiteID: 015-021-002300 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 04/19/2007 ~
SECONDARY CONTAINMENT FOR WASTE FIXER
Release Containment 04/19/2007
---- _ SECONDARY CONTAINMENT ~- ~- - - - - - - - ~ - - - _ ~- - - -"-- --__- __ - -_ -_
Clean Up
CALL COMPANY THAT PICKS UP THE WASTE CONTAINER.
02/27/2007
V1.11C1 lCC.7VUil.:C L'iL L1VGL l.1 V11
-6- 07/12/2007
F KNERR DDS GARY SiteID: 015-021-002300 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
aYc~:la.L ncx~aiu5
Utility Shut-Offs
GAS: N SIDE OF BLDG
ELECTRICAL: W SIDE OF BLDG
WATER: E SIDE OF BLDG
04/19/2007
Fire Protec./Avail. Water 02/27/2007
FIRE EXTINGUISHER W WALL OF DARKROOM.
STA 1 ON H ST.
Building Occupancy Level 04/19/2007
4 EMPLOYEES
-7- 07/12/2007
r
F KNERR DDS GARY SiteID: 015-021-002300 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 02/27/2007 ~
BRIEF SUMMARY OF TRAINING PROGRAM: EXIT DIAGRAM ON WALL IN HALLWAY.
Page 2
Held for Future Use
~ nela =or r~uLUre use
-8-
07/12/2007
KNERR DDS GARY Jam,,`
Manager ~~~'` ~C /",~ ~
Location: 2613 G ST
City BAKERSFIELD
CommCode: BFD STA Ol
EPA Numb:
SiteID: 015-021-002300
BusPhone: (661) 322-1948
Map 102 CommHaz Minimal
Grid: 24D FacUnits: 1 AOV:
SIC Code:8021
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
GARY KNERR DDS / ~/~~ ~ /
Business Phone: (661) 322-1948x Business Phone: ( ) - x
24-Hour Phone ( ) - x 24-Hour Phone ( ) - x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: React
Contact GARY KNERR DDS Phone: (661) 322-1948x
MailAddr: 2613 G ST State: CA
City BAKERSFIELD Zip 93301
Owner GARY KNERR DDS Phone: (661) 322-1948x
Address 2613 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
{used on my inquiry of those individuals
responsible far obtaining th information, I certify
under penalty of law t. t I have personally
examined and a
i '
f ENT'D ~E~
m
am
ar with the information 2 ~ 007
submi ed and b iev. the information is true,
accu nd c pl . e.
_ ,.~ z ~ G
9~ Dat
-1- 02/02/2007
F KNERR DDS GARY SiteID: 015-021-002300 ~
~ 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- 02/02/2007
F KNERR DDS GARY SiteID: 015-021-002300 ~
~ 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:
UTILITY RM CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid TWaste ~ Ambient ~ Ambient PLASTIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
- HAZARDOUS COMPONENTS
oWt. RS CAS#
Silver No 7440224
17.tiGtiiCL HJ JP~J.71~1r+1V 1.7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies R / / / Min
-4- 02/02/2007
F KNERR DDS GARY SiteID: 015-021-002300 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site a
.Agency Notification
rmployee NoLir.~~vacuation
,^
r U1I1ll.: 1VV 1.11. /.GVdC.:Udl,lUil
rJlllCl.yC11C:y 1~1CU1Ud1 Y1dl1
-5- 02/02/2007
F KNERR DDS GARY SiteID: 015-021-002300 ~
Fast Format ~
,~ Mi_tigation/Prevent/Abatemt Overall Site ~
xelease Prevention
xelease containment =
~- `
~ ~ ~L° ~~ ~ t.~
V1.11C1 J.CC~VUI_LC LiUl.lVdl.lUil
-6- 02/02/2007
F KNERR DDS GARY SiteID: 015-021-002300 ~
Fast Format ~
;,-~ Site Emergency Factors Overall Site ~
.7LJCCr 1d 1 1"ld'G dL U~
Utility Shut-Offs
~°I
- ,, .
r s.i.c rtv~.c~ ..~ r~vaii . ~rvc«ci
DlA11 U111y Vla:I,L~Jd11C:y LC V C1
-7- 02/02/2007
~~
F KNERR DDS GARY SiteID: 015-021-002300 ~
- -_ _ _ Fa ~t Fnrma t- ~
Training Overall Site ~
~IR~J1U~/e@ 1Ld1111i1~J
~.
c .~-
l~ ~
~~
~/L. V~ v
rctyC G
Held for Future Use
Held for Future Use
-s- 02/02/200
~'fe''`:---cn~~
+ KRAGEN AUTO PARTS 4290 ______________________________ SiteID: 015-021-003416 +
Manager 'UEr3131E iN1A VC3RE`I
Location: 4500 GOSFORD RD 9
City BAKERSFIELD
Bus Phone : ( ~ ~ I) X13 5 - OSZI f
Map 123 CommHaz High
Grid: 17D FacUnits: 1 AOV:
CommCode: BFD STA 09
EPA Numb:
SIC Code:
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
1~OrjERT W)N7~~~S / p15TR~LT SArGTy M fl,17T SEGVR~TH /
Business Phone: (555 ) ~3~f -a~~(ox Business Phone: (gpp) 8~1l~ -~~~x
24-Hour Phone (~~q ).2~U -~?y x 24-Hour Phone (gDO ) ~y~ -a~~~ x
Pager Phone ( IV~~t ) - x Pager Phone (iV~t1 ) - x
Hazmat Hazards: Fire ImmHlth DelHlth
Contact 3E CO/REG DEPT C/O CSK AUTO INC Phone: (760) 602-8700x
MailAddr: 1905 ASTON AVE 100 State: CA
City CARLSBAD - Zip 92008
Owner CSK AUTO INC Phone: (602) 631-7203x
Address PO BOX 6030 State: AZ
City PHOENIX Zip 85005
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
~ Emergency Directives: ~
PROG A - HAZMAT
PROG H - HAZ WASTE GEN
PROG T - ABOVEGROUND STORAGE TALK./
~~
(~~'o
~$
(~~'~ \
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.
,~
S gnat re Dat
~ ~~~ 1
4 206
-1- 05/-01/2006
~H~pl BAKERSFIELD FIRE DEPT.
HAZARDOUS MATERIALS MANAGEMENT PLAN Preveatioa Services
~~D ~OG~ °'^~D ~ 900 Truxtun Ave., Suite 210
~~tt Bakersfield, CA 93301
i ~* ~.~/4T~ AM>r/ Tel.: (661) 326-3979
I~ . B!S/DES`Spyyl~F3tlOPB~ATORpB~R1RC,p110NFp~lUI ,. ~ Fax: (661) 852-2171 ~/~
' . (HAZARDOUS MATERIALS FACILITY INFORMATION) ,~ Page 1 of 2 ~3 ~11~
. I. FACILITY IDENTIFICATION ~
FACILITY ID NO. t Ysar
5/25 tpo Year Ending
5/25/07 tot
BUSINESS NAME (Same u FACILRY NAME ar DBA- Ooinp Btdnsaa As) s BUSINESS PHONE toe
Kragen Auto #4290 (661) 835-0501
f
A
~ ~ ~
ord Road
45 O
G
os
Bakersfield to. CA 3313 ~
Oo~~~''~~1~~ ~ a~o~iE 5531 ~
~ouNTY
ern t0°
TOR
CQutoiTC. tpa OPERATOR HONE
(602) 631-7203 tip
.:.. .; ...
11: ONYNER INFORMATION.: ~
~:
OWNER NAME ttt OWNER PHONE tt2
CSK Auto, Inc. (602) 631-7203
OWNER MAILING ADDRESS ,ts
P.O. Box 6030
CITY to STATE tts IP na
Phoenix AZ' 85005
. II I. ENVIRONMENTAL CONTACT .
CONTACT NAME to CONTACT PHONE ,ta
3E Company/ Regulatory Department, c/o CSK Auto, Inc. (760) 602-8700
CONTACT MAILING ADDRESS na
1905 Aston Avenue
CITY t7a STATE 721 ZIP to
Carlsbad CA 92008
- PRIMARY -` Iv. EMERGENCY CON TACTS -SECONDARY-
NAME 123 NAME 128
Robert Winters ADT Security (Available 24/7/365 with current phone list)
TITLE 124 TITLE 129
District Safety Manager Store Manager
BUSINESS PHONE 125 BUSINESS PHONE 130
(359)739-2726 (800)848-2872
24-HOUR PHONE 126 24~IOUR PHONE 131
(559)270-7824 (800)848-2872
PAGER NO. 127 PAGER NO. 132
N/A N/A
oOC
~J 133
.
• : . , . ;:.. ..
~ V. CERTIFICATION
Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personaly
examined and am familiar with the information sutxnided in this inventory and bel"lave the information is true, accurate, and complete.
SIGNATURE OF KiNER 138 DATE 134 NAME OF DOCUMENT PREPARER 135
G' ~ 5/25/06 Meghan C. Sadlowski, Agent for CSK Auto, Inc.
NAME OF ER/OPERATOR (SDIGNATURE 8 PRINT) 137 TITLE OF OWNER/OPERATOR 1~e
Meghan C. Sadlowski, Agent for CSK Auto, Inc. Regulatory Compliance Specialist, 3E Company
~Ot FD 2142 (Rev. 09/05)
i~O `~
i `" 1
~~~
HAZARDOUS MATERWLS MANAGEMENT PLAN
ri
SITE & FACILITY DIAGRAM
Page 2 of 2
SITE DIAGRAM
~s BAKERSFIELD FIRE DEPT.
FACILITY DIAGRAM
~~ }
BUSiness Name: Kragen Auto Parts #4290 '
Business Address:
4500 Gosford Road, Bakersfield, CA 93313
A B C D E F G H
1
2
3
4
5
ALLEY
I E ~' SED MOTOR
R cuKBUSTtet,E uQ L
to,
ANT
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ast ~CT1vE alac~wc
EXIT MAIN
® ~ EXIT
~„
VAC NT ® ~ d al
BUI ING ® RESTAU ANT
® ~
~
1--~I
'~. ~'
t
HOUT
I--I
A
MAIN ENTRANCE
E ERGENCY -
AS EMBLY
HYDRAN DRAIN
GOSFOR ROAD
I CAL
3E
NORTH
Please indicate direction of North
FD 2170 (Rev. os/off
Preventioa 8esvices
~I!` 900 Truxtun Ave., Stixite 210
AIT~ Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-21? 1
~g33 ~
UNIFIED- PROGRAM INSPECTION CHECKLIST'
SECTION 1: Business Plan and Inventory Program
~~~y¢~ Prevention Services
„
A ~~ : E R s r ,
~ 900 Truxtun Ave., Suite 210
_
_
~ FiRE `~ Bakersfield, CA 93301
p aRrM ~ Tel.: (661) 326-3979
Fax: (661) 872-2171
FACILITY NAME INSPE ION D TE INSPECTION TIME
~ ~~2 ~` !7 ~ ~~
ADDRESS - ~' ~~
2-61 ~ PHONE NO.
zz~ ~9~ NO OF E LOYEES
FACILITY CONTACT BUSINESS ID NUMBER
15-021- ®15..p 2) ..00
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
~Q ^ 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 _~r D
I
^ EMERGENCY PROCEDURES ADEQUATE . Oo,
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE & ON HAND
~~
ANY HAZARDOUS WASTE ON SITE? ~ YES ^ NO
EXPLAIN: ~~ S}N ~' ~E"'t'
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
Inspector (Please Print) Fire Prevention./ 1" In /Shift of Site/Station # Business Site / Responsible P y (Please Print)
White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05
y' ~,i,
,t'r' ~ 1~
1
FACILITY NAME ~ n E 12 ~, INSPECTION DATE
Section 4: Hazardous Waste Generator Program EPA ID # ~'x ~ ~. p
^ Routine "~ Combined ^ Joint Agency ^Muiti-Agency ^ Complaint ^ Re-inspection
OPERATION C V COMMENTS
Hazardous waste determination has been made
EPA ID Number x£,,.....p ~"
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 /~J
Secondary containment provided
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 ~~~QSo ;~ D ~,~~~
Retains manifests for 3 years
Retains hazardous waste analysis for 3 years
Retains copies of used oil receipts for 3 years ~ ~/4~
Determines if waste is restricted from land disposal
~,=~.ompuance v-vtotanon
Inspector: ~~~'~~'-'S
Office of Environmental Services (661) 326-3979
White -Env. Svcs.
'~'4y` T~`" CITY OF BAI{ERSFIELD FIRE IDEPARTMENT
~~ ~ OFFICE OF ENVIRONMENTAL SERVICES
~' ~ gTNIFIED PROGRAM INSPECTION CHECKLIS
°-~~~g~w 1715 Chester Ave., 3'd Floor, Bakersfield, CA 9330
Pink -Business Copy
~/j~
~`
Business Si esponsible Party