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HomeMy WebLinkAboutBUSINESS PLAN 2/22/2007~-- SCOTT A. TANGEMAN, DDS _ _ ~ 55001VIING AVENUE, SUITE 165 - - i~ ~ - - - E 1 f: TANGEMAN DDS_SCQTT_A_ Manager _E~~'un~-~l-~~~-~©V_t~ ~~ Location: 5500 MING AVE 165 ~• City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: SiteID: 015-021-002277 BusPhone: (661) 323-3071 Map 123 CommHaz Minimal Grid: O1B FacUnits: 1 AOV: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Con tact / Title SCOTT A TANGEMAN / PRESIDENT _ ^ ~ v~,.r,.rjei "nG H~~z~~~.IcI~ _ / OFFICE MANAGER Business Phone: (661) 835-8785x Business Phone: (661) 835-8785x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x _ Pager Phone ( 661) X3;3 .~~~cf ~ ~ ~ Pager Phone ( 6 61) ~O`~- tS~3 l -- Hazmat Hazards: - React Contact ~VGL ~~~vi.e 1kot~C3-~cc~ ~ Phone: (661) 835-8785x MailAddr: 5500 ING AVE 165 State: CA City BAKERSFIELD Zip 93309 Owner 5"~cr~ ~._ta+no~~vraC~,vt Day Phone: (661) 835-8785x Address 5500 MING AVE 165 State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN Eased on my inquiry of those individuals responsible for obtai i h ENT"D BAR ~ 2007 n ng t e information, I certify ~ under penalty of law that I have person«liy examined and am familiar with the information submitted and believe the information is true , accurate, and complete. 07 ~z~ ~ S ture Date -1- 02/16/2007 <, F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... ~ecHa~EPA Hazards) Frm I DailyMax 'IUnitIMCPI WASTE FIXER R L 5.00 GAL Minl -2- 02/16/2007 -3- 02/16/2007 F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ ~ 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 T PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste ' Ambient ~ Ambient ~LASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL • HAZARDOUS COMPONENTS %Wt. RS CAS# Silver No 7440224 r11iGriRL tiJ .7P~.7.71.1P~1V 1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/16/2007 F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification Employee Notif./Evacuation ,~ rw~l ice. ivv a.ii ~ Lva~.ua~.l vti Emergency Medical Plan -5- 02/16/2007 F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention Release Containment G/ Call ~o•~.~av~y \~ ~C C'~„v~ c~7cs\v.,qs: cs•~S ~~ t v i ~ ~,. 1.,n C. v~..iici ncavui~.c tal.l.1V0.V1V11 -6- 02/16/2007 ~7 ~ V ~, 1~ ~ ,i ~. F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ Fast Format ~ Site Emergency Factors Overall Site ~ aNc~iai nac,aLU~ 1`~~v~ (-}ve Rbc'-t~ Side ©~ 5~se~-~- Du11U111c,. VC: C:U~Jdi1C:y L~Ve1 Jr ~rnQ~~~Q.~ `:~ -7- 02/16/2007 r~ ~~~~~ COLLINS DC CURTIS BusPhone: Map 123 Grid: lOB SiteID: 015-021-00297 (661) 836-2226 CommHaz Minimal FacUnits: 1 AOV: Manager CURTIS COLLINS DC Location: 5500 MING AVE 170 City BAKERSFIELD CommCode: BFD STA 07 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title CURTIS COLLTNS DC / OWNER / Business Phone: (661) 836-2226x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x .............. Hazmat Hazards: React Contact CURTIS COLLINS DC Phone: (661) 836-2226x MailAddr: 5500 MING AVE 170 State: CA City BAKERSFIELD Zip 93309 .............. Owner CURTIS COLLINS DC Phone: (661) 836-2226x Address 5500 MING AVE 170 State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: `t~ PROG H - HAZ WASTE GEN ~OI ~~ ENS"~ ~ R R 5 20Q7 . Based on my mquirY the info matioa! 1 deaifY i ng ersonally responsible for obtain nalty of law that I have p tion under pe examined and am familiar with the informa formation is true, i n submitted and believe the accurate, and complete. ~-~ ~1 Date Signature -1- O1/29/2t)07 .~ T F COLLINS DC CURTIS ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-00297 ~ By Facility Unit ~ Fixed Containers at Sites ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 5.00 GAL Min -2- Ol/29/2~07 -3- Ol/29/~007 F COLLINS DC CURTIS SiteID: 015-021-00297 ~ ~ 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# Liquid TWaste ~ AmbRient~E ~ AmbientT~E ~PLASTOICTCONTAINERE Largest Container 5.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 5.00 GAL Daily Average 5.00 GAS t1HGKKLUUJ 1:U1~lYV1Vi'~1V1J %Wt. RS CAS# Silver No 7440224 riAL~HKL H ~~i55~1Y11";1V"15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MC1 No No No No/ Curies R / / / Min -4- 01/29/2b07 f> ,l F COLLINS DC CURTIS SiteID: 015-021-00297 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ r. ri~cit~.y 1VVl.J.11~.Ci1~1V11 rJIllN1VyCC 1VV1.11 . /.GVdC:Udl,1Vi1 t'U1J11C: 1VV1.11 / ~VdUUdL1V11 ~lneryency rieaical rlan -5- 01/29/2n07 7~ ,q F COLLINS DC CURTIS SiteID: 015-021-002978 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Sits ~ LtG1G0.i7G r1G V 6111.1 V11 itG1G0.w7C \. V111.0.11111LC11L V 1.110 1. 1CC~VUI C:C L"~C:L1VdL1OI1 -6- O1/29/2b07 F COLLINS DC CURTIS SiteID: 015-021-002970 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ Special Hazaras Utility Shut-Offs mire rrotec.~r~vail. water isuiiaing occupancy Level -7- 01/29/2007 i, iM. F COLLINS DC CUR.TIS SiteID: 015-021-0029`78 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training rayc ~ nctu ivi ru~.ul.c vsc n~lu iui ru~uie use -8- Ol/29/~007 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY N *ME INSPECTION DATE INSPECTION TIME ADDRESS ~ `~ ~ V l~-~ • 1~--tee. - - J PHONE No. & 3G ~ ~~ No. of Employees ---_~-- ------- FACILITYCONTACT ~ Business ID Number - 15-021- (~ O x-47 $ Section 1: Business Plan and Inventory Program a?,~ ~, ~: Routine. ^ Combined ^ Joint Agency ^ Muiti-Agency O Complaint ^ Re-inspection C V innce~ OPERATION t COMMENTS o \V=Voa ^ APPROPRIATE PERMIT ON HAND ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ~I ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES KJ u VERIFICATION OF LOCATION - - L C~' ^ - - ----------- ------ PROPER SEGREGATION OF MATERIAL ---- ------.._.---- - ^ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF FIAT MAT TRAINING ---- -- --- ----------------- - - - fi ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES -- - - -- ~ ~®~ ~ s/ ~OOU ^ - - ------ ------ EMERGENCY PROCEDURES ADEQUATE ---------------------------------------------------------- ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ------------ -------------------------------------------'--- E QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~CF)'I~ 328-3979 y r __________ ~ ~/ 1 ~ __ _ ___ nspector Badge No. Business Site Responsible Party White -Environmental Services Yellow -Station Copy Pink -Business Copy ANY HAZARDOUS WASTE ON SITE?: YES ~NO L•' - i~ COLLINS DC CURTIS SiteID: 015-021-002978 Manager CURTIS COLLINS Location: 5500 MING AVE 170 City BAKERSFIELD BusPhone: (661) 836-2226 Map 123 CommHaz Minimal Grid: 10B FacUnits: 1 AOV: CommCode: BFD STA 07 EPA Numb: STC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title CURTIS COLLINS DC / OWNER / Business Phone: (661) 836-2226x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact CURTIS COLLINS Phone: (661) 836-2226x MailAddr: 5500 MING AVE 170 State: CA City BAKERSFIELD Zip 93309 Owner CURTIS COLLINS DC Phone: (661) 836-2226x Address 5500 MING AVE 170 State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers Tot alUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN b JUG ~ ~ ~~~p E32sed on my inquiry of those individuals respc?nssble for obtaining the information, I certify under penalty of law that I have personally examined and am familiar ~rvith the information submitted and believe the information is true, accurate, a d complete. 6 2~~ ! Date Si : ,atur , -1- 07/10/2007 r. F COLLINS DC CURTIS SiteID: 015-021-002978 ~ ~ 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- 07/10/2007 -3- 07/10/2007 F COLLINS DC CURTIS ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit UTILITY RM SiteTD: 015-021-002978 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWasteAmbient ~_Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL ri1~G1-1KLVU~ 1.:V1~lYV1VL'1V1J %Wt. RS CAS# Silver No 7440224 ru~~tircL r~55r~aai~i~lvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/10/2007 F COLLINS DC CURTIS SiteID: 015-021-002978 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification _ ~ r / .-. P~Lll~J1VyGG 1VV 1.11. ~ l~V Q~.U0.1.1 V11 i .-. t U1J111: lVV l.11 / L' Vdl.:LLd1.1 Vl1 P~lllCtt~. Clll: ~/ 1~1C U11.:d1 t'1d11 -5- 07/10/2007 F COLLINS DC CURTIS SiteID: 015-021-002978 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention iCC1C0.C7G \..Vll l.Q 111L11G11L Clean Up 04/05/2007 WE WILL CALL THE COMPANY THAT SUPPLIES US WITH THE MATERIALS. THEY HAVE A HAZARDOUS MATERIALS CREW. Vl..lict itc .~VU1 ~.G tll. l„1V0.1.1 V11 -6- 07/10/2007 F COLLINS DC CURTIS SiteID: 015-021-002978 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~JCC:1d1 Lld'GdLUS l.11~1111.y •711UL-V11.7 l 1.LC r1 Vl~C lr/tiVQ11 YYQ I.Cl. a1.111~A 111y VI: I: U~J 0.111:y LCVC1 -7- 07/10/2007 .~ ;• F COLLINS DC CURTIS SiteID: 015-021-002978 Fast Format ~ Training Overall Site ~ Employee Training ruyc ~ Held for Future Use _, t_ aaciu ivt i~u~..utc v.7c -8- 07/10/2007 n ~ TANGEMAN DDS SCOTT A SiteID: 015-021-002277 Manager EVANGELINE HOWARD Location: 5500 MING AVE 165 City BAKERSFIELD BusPhone: (661) 835-8785 Map 123 CommHaz Minimal Grid: O1B FacUnits: 1 AOV: CommCode: BFD STA 46 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title SCOTT A TANGEMAN / PRESIDENT EVANGELINE HOWARD / OFFICE MANAGER Business Phone: (661) 835-8785x Business Phone: (661) 835-8785x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661) 333-8093x Pager Phone (661) 204-1537x Hazmat Hazards: React Contact-s-EVANGELINE-HOWARD --. ~ -"" Phone: (661) 835-8785x MailAddr: 5500 MING AVE 165 State: CA City BAKERSFIELD Zip 93309 Owner SCOTT A TANGEMAN DDS Phone: (661) 835-8785x Address 5500 MING AVE 165 State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN Oased 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 subrr~itted and believe the information is true, accur e, and complete. ~ ~lXAG 8 ~i ature Dat -1- 10/03/2007 1 F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ ~ 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- 10/03/2007 z>. -3- 10/03/2007 F TANGEMAN DDS SCOTT A SitelD: 015-021-002277 ~ ~ 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 ~ Ambient ~ Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5 . 0 0 GAL 5 . 0 0 GAL { oJo~ -~9-- GAL - t1HGHKLVU~ 1.:V1~lYV1VL'1V1"~ SWt. RS CAS# _~" - Silver- -- - ---- ----- --_ ~ __ -- - - - __ No _ ___--._ -- 7440224 riAGH!<1J A~~C~~51~11';1V1"~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 10/03/2007 F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification Employee Notif./Evacuation ,_ , ,~ rUiJlll. 1VVL11 . ~ L~V0.l~UQl.,1Vll I:i lllC j. l~. C11C: ~/ 1"1C U1Gd1 Yldil -5- 10/03/2007 c 'i F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention Release Containment Clean Up 03/01/2007 CALL X-RAY SOLUTIONS SERVICE INC, 4700 EASTON DR 45. V1.11G1 2<C w7V Ut l~C t~l.L1VCLL1Vil -6- 10/03/2007 F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~rc~:iui nct~.aiu~ Utility Shut-Offs 03/01/2007 ELECTRI"CAL --BACK-OFFICE'-WALL-PANEL ADJ~TO E-ENTRf` WATER - BACK OFFICE SWITCH BY UTIL RM ADJ TO E ENTR Fire Protec./Avail. Water 03/01/2007 SPRINKLER SYSTEM AND FIRE EXTINGUISHERS. FIRE HYDRANT - MING AVE N SIDE OF ST. Building Occupancy Level 03/01/2007 5 EMPLOYEES -7- 10/03/2007 -~ F TANGEMAN DDS SCOTT A SiteID: 015-021-002277 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training Page 2 nciu ivt ru~uic u~c ncl.u tui ru~utc uac -8- 10/03/2007 t~vSA: f~-E~...~ UNIFIED PROGRAM INSPECTION CHECKLIST -~u~ SECTION 1 Business .Plan and Inventory Program FACILITY~NApME ~ WSPE~ION DATE INSPECTION TIME r l / _..- ADDRESS ~J PHON No. No. of Empbyees l f ` '_, _ _._ _ ---- --- _-- - - _ . ---- ---------- - ---___ . _ _ _ !o--- -_ _ _ _ __ __. _ -- - -- ------ - - - . --- _ _ - --._ __. ---- ------- --- - FACILITYCONTACT Business ID Num ~ -OZ ~ - /~ ~ Section 1: Business Plan and Inventory Program X97 $ ^ Routine Combined ^ Joint Agency ^Mutti-Agency ^ Complaint ^ Re-inspection Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 9330. Tel: (661)_326-397_ ~_? f ?~r~ C V ~ V=vo ationnCe l OPERATION COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ HOUSEKEEPING ^ ^. FIRE PROTECTION ~ ^ ^ SITE DIAGRAM ADEQUATE ~ ON HANG ANY HAZARDOUS WASTE ON SITE?: ~'_YES ^ NO EXPLAIN: (/`~Il~>7 Cam' ~X-c."~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~GG') ~ 326-3979 i ---------~ ~ ------------ ----------------- _-f -3__.._.._____ ._ _ _ Inspector (Please Print) Fire Prevention 1st-In/Shift of Site sines Site Responsible Party (Please Print) B White -Environmental Services Yellow -Station Copy Pink -Business Copy t~,~-rar ~k ---_ ~I ~.. . , ;. P4~4`~LD Fj~~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES ~' •y UNIFIED PROGRAM INSPECTION CHECKLIST `k•F"~ gti~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME ~R- C~.~z-ns co~.c.~./s ~-G INSPECTION DATE ~-I Z~/Us" Section 4: Hazardous Waste Generator Program EPA ID # ~/ n" ^ Routine ~----Combined ^ Joint Agency ^hulti-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 line Secondary containment provided ~~~~~ P~~~E Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels I I Proper management of used oil filters Transports hazardous waste with completed manifest ; Sends manifest copes to DTSC ~ -- -- I Retains manifests for 3 years j Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal C=Compliance V=Violation Inspector: 1.~ ~ -JL''~ Office of Environmental Services (661) 326-3979 White -Env, Svcs. Office Hours By Appointment Phone (661) 836-2226 Fax (661) 836-2223 DR. CURTIS COLLINS, D.C. 5500 Ming Ave., Ste, 170 Bakersfield, CA 93309 Pink -Business Copy Business Site Responsible Party