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Home My WebLink AboutBUSINESS PLAN 7/26/2007r ,~~~ ~~~ ~ _ I L ;_ ~ h~N ~~ iKAISER PERMANENTE - (East Hills) ~ ;3700 MALL VIEW ROAD ~ ~ ~~ (~~ ~l lc~ l ~~ ~~ W '~!' J'\~`~ l -. L, ~ ~ i~° ,, 'i ~r \~ ~,. ~ ~~, . _ ..~, ~i j~ ~ •-~ KAISER PERENTE Q,r/- Manager Location: 3700 MALL VIEW RD City BAKERSFIELD CommCode: BFD STA 08 EPA Numb: BusPhone: Map 103 Grid: 22B SIC Code: DunnBrad: SiteID: 015-021-000883 (661) 334-2992 CommHaz Low FacUnits: 1 AOV: Emergency Con act / Title Emergency Contact / Title J / DEPT ADMIN RICK MATTHEWS / SECURITY MGR Business Phone: (661) 334-2992x Business Phone: (661) 852-2797x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661), 634-7002x Pager Phone Hazmat Hazards: ~~y. ~ ~~ Fire React ImmHlth DelHlth Contact `-~~i ~ y Phone: (818) 405-6566x MailAddr: ~(~ ~mi- 1 ZOg ~ State: CA City P~ j~ /C~/5~~~ Zip 91188 vv ~ / Owner KAISER/PROPERTY AC ISITIONS Phone: (818) 405-6566x Q U Address 393 E WALNUT ST State: CA City PASADENA - Zip 91188 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ANT°D J ~ 1. ~ ~. X007 t3ased on my inquiry of those individuals ible for olata~ning th , ~ ro~ mation, 1 certify respons under penalty o'r la ~ t a/~ ' ,ave personally '` ith the information il ia examined ~•.~d ~ • ~am de!1e~~~1e information is true, ~: ar' .~ submitte accur~'a, a' d ompt~'.-. ~7 Si naiure D~ e -1- 07/12/2007 F KAISER PERMANENTE SitelD: 015-021-000883 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN F IH DH G 770.00 FT3 Low WASTE FIXER R L 5.00 GAL Min -2- 07/12/2007 '3' 07/12/2007 ~ KATSER PERMANENTE SiteID: 015-021-000883 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: UTILITY CAS# 7782-44-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Gas TPure -Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Co390100rFT3 Daily M~Ol00m FT3 I Daily A~Or00e FT3 - r1H~~lcLUUa ~vl~iruivr~ly 15 %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 riHGAJ.<L A751;~a1~11;1V'1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit Map: Grid: RADIOLOGY DARKROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste ~ Ambient ~ Ambient ~LASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 3.00 GAL nr~c~s~tcl~uua wl~lrulv~ly 1 ~ oWt. RS CAS# Silver No 7440224 1'1HGHKL 1~.7 .'~I;b.71~11;1V 1.5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ ~ Curies R / / / Min -4- 07/12/2007 F KAISER PERMANENTE SiteID: 015-021-000883 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 05/20/1998 ~ CALL FIRE DEPT AND NOTIFY ADMIN OFFICE. Employee Notif.jEvacuation 05/20/1998 USE PAGING SYSTEM AND LOCK DOOR TO ROOM. Public Notif./Evacuation 10/05/2006 WITHIN BLDG, USE PAGING SYSTEM AND ESCORT EMPLOYEES TO A SAFE AREA. Emergency Medical Plan 07/12/2006 SEE DOCTOR AT FACILITY, IF REQUIRED. -5- 07/12/2007 ~. `t F KAISER PERMANENTE __ SiteID: 015-021-000883 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 07/12/2006 ~ KEEP OXYGEN TANKS CHAINED TO WALL. BAG ALL WASTE AND STORE IN LOCKED ROOM. Release Containment 04/23/2007 N/A Clean Up 10/05/2006 DISINFECT WITH MOP AND SPONGE. V1~11C 1. 1CC.7-V U1.LC 1-1C: l.1Vdl.l Vil -6- 07/12/2007 F KAISER PERMANENTE SitelD: 015-021-000883 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ especial nazaras Utility Shut-Offs GAS - REAR LOADING FOR PHARMACY IN GATE ELECTRICAL - REAR BACK RM WATER - FRONT AT ST LARGE VALVES 04/23/2007 Fire Protec./Avail. Water 12/13/2006 PRIVATE FIRE PROTECTION - SPRINKLERS, FIRE EXTINGUISHERS, AND SONITROL ALARM SYSTEM. NEAREST FIRE HYDRANT - ON- AND OFF-SITE. Building Occupancy Level 03/10/2006 55 EMPLOYEES -7- 07/12/2007. F KAISER PERMANENTE SiteID: 015-021-000883 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/05/2006 ~ MSDS SHEETS ON FILE AT THIS FACILITY. BRIEF SUNIMARY OF TRAINING PROGRAM: EMPLOYEES ARE BRIEFED ON PROPER STORAGE AND HANDLING (ONLY SOME DO HANDLE). QUANTITIES ARE MINIMAL (JUST VACATE ROOM AFFECTED). IF PROBLEM PROCEEDS, CALL SUPPLIER OF OXYGEN OR COMPANY WHO PICKS UP MEDICAL WASTE. EMPLOYEES COMPLETE A LIVE FIRE TRAINING COURSE UNDER THE DIRECTION OF AMERICAN FIRE SAFETY. EMPLOYEES HAVE BEEN BRIEFED ON THE MSDS FORMS AND KNOW WHERE THIS INFORMATION CAN BE ACCESSED. EMPLOYEES ATTENDED A PRESENTATION BY INTEGRITY MEDICAL GAS SERVICES ON THE PROPER HANDLING OF OUR OXYGEN SYSTEM. rayc ~ Held for Future Use nciu ivi ru~uic ~5c -8- 07/12/2007 UNIFIED PROGRAM INSPECTION CHECKLIST: SECTION 1: Business Plan and Inventory Program • • YES ^ NO QUESTIOPNS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 • v Inspector (Please Print) Fire Prevention / 1~` In / h of Site/Station # B iness Site Res o Bible Party (P s rint) Prevention Services e A e R S. ~ ,, p 900 Truxtun Ave: , Suite 210 P/RE Bakersfield, CA 93301 aRrM Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ' r ~ M INSPECTION DATE ~~ ~"~--c~ G INSPECTION TIME 2~ ~ ~ "--~ ADDRESS - 1 - .3 moo ./-~ v. e ~,.~ PHONE NO. NO OF EMPLOYEES o FACILITY CONTACT ^, ,.,,/ '~ C~ G__~~v'~!'~"1 ~ _ BUSINESS ID NUMBER 15-021-~~Q~~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 ^ ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ VERIFICATION OF INVENTORY MATERIALS O ^ 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 ENr~ ^ EMERGENCY PROCEDURES ADEQUATE ZOO ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business .Plan and Inventory Program Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661)_326-3979 __ FACILITY NAME WSPECTION DATE INSPECTION TIME ADDRESS PHONE No. No. of Employees -3- ~ ° ~----~~~ --- -Ur ~ w.--------- - ..-- - 3~y - ~ ~7 -. ----'~-~-- 1I .------.-----.. __ -._------- _ -._ _ _- -- _- _ t3usines810 Number FACILITYCONTACT 15-021- cxx~g~3 Section 1: Business Plan and Inventory Ptrogram j~ Routine O Combined ^ Joint Agency ^Mnlti-Agency O Complaint ^ Re-inspection • C V \ V=Vio aplonnCe) OPERATION COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE 1"- ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ~. ^ ~ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ .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 ~, ^ HOUSEKEEPING -. _. _ ^. FIRE PROTECTION ^ SITE DIAGRAM ADEOUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: ^ YES ENO EXPLAIN: • QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~66~ ~ 326-3979 Inspector Ple~e Print Fire Prevention 1st-InfShitt of Site White -Environmental Services Yelk>rv - Slelion Copy Business Site R tdble arty (Please Print) ~ Pink - t3usine88 Copy UNIFIED PROGRAM - ~.~ECTION CHECKLIST SECTION 1 Business Plan and Inventory Program /~ Bakersfield Fire Dept. y Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPECTION DATE INSPECTION TIME ~-~S CYL `7-Z-o3 /o ~.~ _ ADDRESS PHONE No. No. at Employees FACILITYCONTACT Business ID Number 15-021- ocx~BF~~ Section 1: Business Plan and Inventory Program Routine ^ Combined ~ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V nce~ OPERATION ti COMMENTS on \V=Vba ^ APPROPRIATE PERMIT ON HAND ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY `J ^ VERIFICATION OF INVENTORY MATERIALS ^- '~ VERIFICATION OF QUANTITIES - ^ ^ 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 ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE ~ ON HAND ANY HAZARDOUS WASTE ON SITE EXPLAIN: ^ YES ~No QUESTIONS EGARDING THIS INSPECTIONS PLEASE CALL US AT ~GG'I ~ 326-3979 -1- - --------- -- _ - -3- ------------ In ctor Badg No. Waite - Env~ronmenlal Services Yellow - Stelan Copy usiness Site esponsi le Pa y Pink -Business Copy • - i ~ ... + KAISER PERMANENTE ___________________________________ SiteID: 015-021-000883 + Manager Location: 3700 MALL VIEW RD City BAKERSFIELD CommCode: BFD STA 08 EPA Numb: BusPhone: (661) 334-2900 Map 103 CommHaz Low Grid: 22B FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title / ADMINISTRATION J~i-i~ / ADMINISTRATION Business Phone: (661) 334-2992x Business Phone: (661) 33-x=26-66x 2 4 -Hour Phone ( ) - x 2 4 -Hour Phone ( 6 61) 3-~ 8--~-8-31 x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Reac t ImmHlth DelHlth Contact Phone: (818) 405-6566x MailAddr: 393 E WALNUT ST State: CA City PASADENA Zip 91188 Owner KAISER/PROPERTY ACQUISITIONS Phone: (818) 405-6566x Address 393 E WALNUT ST State: CA City PASADENA Zip 91188 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ENT'D JU 12 ~ PROG A - HAZMAT PROG H - HAZ WASTE GEN LI\ 1 V J V L 1 !.~ LUUO ~53~~~~ ~s°°~ Based on my inquiry of those individG~als responsible for obtaining the information, I certify under penalty of I w that I have personalty axamined and amili information s«bmitte n eli a nformation is true, accura om e i ~~6 - ~./~ ~ OG Signature i Date ~s',~ ~ °~i~..P ' GG~ -~~~-~ 992 ~~ 1 tit .era c ~°'~, ~{ ~ ~~ ~~~~~s /~ .~ ~ ~~ ~, -1- 06/28/2006 i// ~~ _ ~ ~ ~~~ ~ ~o~, C .mica! is i ..:C _ n S{ae Q ,. H Ftt~mmA N C.c~ 'R tt~t ~ ~ ; ~t ' Aoaent Pfus X 540 ml a 20 E8H Ase io Wi s X 1 ib a x 20 1 1 0 0 E8H Cidex X 1 ai 4 2 0 0 E8H Endue 300 Waterless el X 840 ml a 20 E8H Endure 420 Clda 8tat X 540 mi a 20 1 3 0 E8H Formaldeh de X 15 m{ a x 200 2 2 0 E8H H d en Peroxide X 473 ml 10 2 0 2 1 E8H lod{ne X 472 ml 10 0 0 2 1 E8H lodoform-Triiodomethane X 5 ds 10 0 0 2 1 E8H {so ro 1 Atoohol X 473 rnl 3 4 1 2 E8H Ox en X La e/ rtabie 4/6 0 4 0 2 E8H Pe rmint OII X lox 10 E8H Rea ent Alcohol X 1 al 1,8 1 3 0 - E8H 811rradene 1 % Dream X tubes/ an E8H/Pharma 81{ver N{trate X s{n le dose 100 3 0 2 3 E8H Silver Nitrate A Ilcators X 1 1 0 E8H/Pharma Sodlum Bfoarbonate X 50 mi 8 1 0 0 1 E8H UC8 fl u/s cleanin sol X 1 liter 1A sl, mod, sl. 0 E8H Wash Skin oleanser 840 mi a 20 E8H Li uid Nitro en X 1 container 1 ESH Chlora re Swabs ~ X sin to dose a 100 ESH ~.., ~~ ~~~ ,.y ~~: REV: 8/08 Page 1 0} 1