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HomeMy WebLinkAboutBUSINESS PLAN 7/18/2007,~ '~ ° - - SAGEPOINT DENTAL 6405 MING AVE. `~ ~ A ~~'~. _-.~ *' 5 ,.; SAGEPOINTE DENTAL Manager WARREN BARB Location: 6405 MING AVE City BAKERSFIELD BusPhone: Map 123 Grid: l0A SiteID: 015-021-000008 CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: (661) 834-9900 CommHaz Minimal FaCUnits: 1 AOV: Emergency Contact / Title Emergency Contact / Title WARREN BARB / PRESIDENT / Business Phone: (661) 834-9900x Business Phone: ( ) - x 24-Hour Phone (661) 834-9900x ~ 24-Hour Phone ( ) - x Pager Phone (661) 303-4269x .Pager Phone ( ) - x Hazmat Hazards: React Contact WARREN BARB Phone: (661) 834-9900x MailAddr: PO BOX 12004 State: CA City BAKERSFIELD Zip 93389-2004 Owner Phone: (661) 834-9900x Address 6405 MING AVE 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 ~ ,r°Y ~gr~° .. _~~ . ls d ~•~,J,,~-~~ ua 3ased on my inquiry of those indivi the in#armation, I r.,4rtify . ~,, ~J` ' ~~ respan:~iie ir~r o:~~:airr~nq under penalty of ia'.~; that ! have personally m tamdiiar vNith the int®rmation d ~' ° - a examin d a.n ?c~ and oplieve the information is true, ubmitt ~ ~ r ~~ __n p . s accurate, and camp-ete• - _ . ~- mate Signature ~NY'~ J U ~ 2 4 2007 -1- 07/16/2007 t _°P~ ~! F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 1.00 GAL Min -2- 07/16/2007 LOOZ/9T/LO -£- ^~ ~=. ~~ w u F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit Map: Grid: DARKROOM CAS# STATE T TYPE PRESSURE TEMPERATURE ~~ CONTAINER TYPE Liquid I Waste Ambient ~ Ambient I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 1.00 GAL 0.13 GAL t"lti~~,tcuvu~ ~ul~lrul~l;iv1~ oWt. RS CAS# Silver No 7440224 tla'~GHKL A55L•~551~1L"~1V'1"5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/16/2007 ._ ri. 1~ 3 F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/03/1999 ~ AGENCY WILL BE NOTIFIED BY FRONT DESK STAFF IN THE EVENT OF NECESSARY EVACUATION. FRONT DESK PERSONNEL WILL CALL NECESSARY 911 HELP AS INDICATED BY EMERGENCY. Employee Notif./Evacuation 09/22/2006 ALL PATIENTS AND STAFF ARE NOTIFIED PER EMERGENCY PROCEDURES. 911 IS CALLED AND NECESSARY ACTION IS TAKEN. Public Notif./Evacuation 09/22/2006 ANY STAFF MEMBER CAN ADDRESS PUBLIC FROM ANY INTERNAL PHONE LOCATION BY PUBLIC ADDRESS ON PHONE. WITH THE EXCEPTION OF CATASTROPHIC EMERGENCY, THE FRONT DESK ASSUMES THE DUTY OF PUBLIC NOTIFICATION. EXITS ARE MARKED AND CONFERRED WITH PUBLIC ADDRESS INSTRUCTIONS. Emergency Medical Plan 09/22/2006 STAFF IS INSTRUCTED TO CALL HALL AMBULANCE AT 327-4111 FOR MEDICAL EMERGENCY OR 911. -5- 07/16/2007 4 ~ .~' J F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ Fast. Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 07/25/1990 ~ TANKS OF HAZARDOUS MATERIALS ARE: CHAINED TO THE WALL, ALL FITTINGS ARE APPROVED, LINES ARE REGULATED AT THE TANK WITH APPROVED REGULATORS. Release Containment 07/25/1990 IMMEDIATELY EVACUATE ALL PERSONNEL FROM DANGER AREA. SHUT OFF LEAK IF WITHOUT RISK. VENTILATE AREA OF LEAK OR MOVE LEAKING CONTAINER TO WELL VENTILIATED AREA. Clean Up 07/25/1990 KEEP PERSONNEL AWAY. DISCARD ANY PRODUCT RESIDUE, DISPOSABLE CONTAINER, OR LINER IN AN ENVIRONMENTALLY ACCEPTABLE MANNER. v~,iici nc.7vui~.c t]1:1.1VQ1.1V11 -6- 07/16/2007 ` 9; F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~Nv~:la~. na~aiu5 Utility Shut-Offs 04/11/2007 GAS - SE CRNR OF OFFICE S OF FIRE ACCESS HALL ELECTRICAL - MAIN PANEL MID E SIDE OF BLDG WATER - ATTIC DROP CEILING SW CRNR OF OFFICE ELECT SOLENOID SWITCH E SIDE S END OF CNTRL HALL SPECIAL - SW END CNTRL HALL SHUT-OFF 02 Fire Protec./Avail. Water 01/11/2007 PRIVATE FIRE PROTECTION - CLASS A, B, C, FIRE EXTINGUISHER S END OF CENTRAL HALL. SMOKE DETECTORS IN LAB AND CENTRAL HALLWAY. FIRE HYDRANT - W SIDE CHESHIRE ST OUTSIDE BLDG MIDDLE OF BLDG. Building Occupancy Level 03/10/2006 6 EMPLOYEES -7- 07/16/2007 n F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training 09/22/2006 MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: BI-ANNUAL CPR REQUIRED FOR RDA ASSISTANTS, ANNUAL REVIEW OF MSDS SHEETS AND VCR TRAINING PRESENTATION. UNANNOUNCED EMERGENCY DRILLS. Held for Future Use nC1U 1VL rul. l.LLC V5C -8- 07/16/2007 BAKERSFIELD FIRE DEPT Prevention Services `UNIFIED PROGRAM INSPECY'ION CHECKLIST n F!R/! n 900TruxtunAve., suite 210 ~..,....-~~,.:..<:-~.~.;.~_, . <.. ,.{.~ ~:.:.:...E.., ~ ... „ :; . E>r..:,:- ; .,w~.-. ,..~- wRrA1 s Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ~ Tel.: (661) 326-3979 • Fax: (661) 872-2171 FACILITY NAME ((~~ INSPECTION DATE INSPECTION TIME ADDRESS O NE NO. H O OF EMPLOYEES !e O nJly t/ G ~y 3 o.J~" [700 FACILITY CONTACT USINESS ID NUMBER 15-021- Qoe~~y~ O ~ D ~ ~ ~. ~- Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION • C V ~ C=Compliance OPERATION V=Violation COMMENTS ~6J' ^ APPROPRIATE PERMIT ON HAND - lid' ^ BUSIf12SS PLAN CONTACT INFORMATION ACCURATE ~ ^ VISIBLE ADDRESS / GY ^ CORRECT OCCUPANCY 6?~ ^ VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY n `/~ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PRO CEDURES / Ld' ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? L"~fYtS ^ NO EXPLAIN: ~ I X~~~ ~~. ~ F/ / KJ u --_-_- ---- - • QUESTIONS REGARDING THIS INSPECTjjION? PLEASE CALL US AT (661) 326-3979 111 6C/'-' ! //-~ Inspector (Please Print) Fire Preventio / is' In /Shift of Site/Station # Business Site/Sch I Site Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02/05) ~ ~ gb3 ~. Prevention Services UNIFIED PROGRAM INSPECTION CHECKLISTi Suite 210 900 Truxtun Ave. R F a S F _, „ F,tee , Bakersfield, CA 93301 SECTION .-1: Business Plan and Inventory Program gerM r Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~~ ~ ^~ ) INSPE/~TION DATE ~ a/ ~ INSPECTION TIME j o~ n-~ 1Je n~c / ~ ADDRESS 6 ~ a S ,~ ~ >1~ fl>7 ~ PHONE NO. ~~-~ ^ ~~~ NO OF MPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 15-021- ©if S ^oZJ , ,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 ^ BUSInBSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES _ ,,, r . ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ~B ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~~ ^ EMERGENCY PROCEDURES ADEQUATE 1B ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION CT ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ~~~ YES ^ NO ~G S'Y@ .~1 k E 6+ EXPLAIN: '° o QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 c ~~~~- Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Business Site /Responsible Party (Please Print) Pink -Business Copy FD 2155 (Rev. 09/05 '~ r,: ~" a0,4~' Tai" CITY OF BAKERSFIELD FIRE DEPARTMENT ~~ ~~ OFFICE OF ENVIRONMENTAL SERVICES ~t° , • • ~~$ UNIFIED PROGRAM INSPECTION CHECKLIST =„~~,~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME S ~E Po ~ NT 17r; `v'/ ~b ~. INSPECTION DATE ~• ~ a ~ 7 Section 4: Hazardous Waste Generator Program EPA ID # ~ ~' ~ '"' P ~' ^ Routine -~l Combined ^ Joint Agency ^Muiti-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 Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste ~ Proper management of lead acid batteries including labels N ~ Proper management of used oil filters PJ Transports hazardous waste with completed manifest nn ® L 1~ !~ ~ o~ '^~T t~~ Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years ~~-~ ~ Determines if waste is restricted from land disposal ., .,.,...r..a....., . - . n„auuu ~ Inspector: li ~~~~-' 7 Office of Environmental Services (661) 326-3979 White -Env. Svcs. ., Business Site Responsible Party Pink -Business Copy 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 NAME O'j ~ A~-= r ~ Po x ~ Q ~~ ` ~ INSPEC ION TE ~ ! ! ~~ INSPECTION TIME ~ M ~ ~ v s ! __ _ _ __ . ~ i K,~ ~- q ~--.---- ---- ------- ------------- - ~ ' ----- ADDRESS `\O~ `` _ PHO E N _ _ ___ _ . No. of Employees _ 6 dos--~1~; <., ---~-~~--=---------------- - --------- ~3~-4400 -- --7--_ _ FACILITYCONTACT Business ID Number is-o21- ~~o~ 8 Section 1: Business Plan and Inventory Program C~'F2outine ^ Combined O Joint Agency ^Muiti-Agency ^ Complaint ^ Re-inspection C V C=Compliance OPERATION COMMENTS V=Violation APPROPRIATE PERMIT ON HAND ^ A 1~c3 ~L.O G F,~, ~-rte /1.E0't C ___ __ / L~J ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE _ _ _ __ _ _ - C~ ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ~i-~ ^ I..ty VERIFICATION OF INVENTORY MATERIALS /~ ~ ~' _ - -------------- ^ V _ _ --- - --• - ---------- O !.-o~t.~-~ C.~F~K-Y /U i7 a'~~j----~ N ERIFICATION OF QUANTITIES ~ ~ ._ LJ! !J VERIFICATION OF LOCATION lD~VV PROPER SEGREGATION OF MATERIAL fi~ `~ », ~ r ' VERIFICATION OF MSDS AVAILABILITYE ' Ld ^ VERIFICATION OF FIAT MAT TRAINING yLT' . ~ j 3 Q x~/ G o~ f~ LI ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ q ,~~ ~~Cy ~'~ ; ~ ~-` ~^ EMERGENCY PROCEDURES ADEQUATE r ~> -' '' ' ^ CONTAINERS PROPERLY LABELED / .-; ~ ~;~~ _ \ !~' t ,. ,,,.. ;.y' ... ;~,~ ,.{v.'Jr,~~'~,,,~ "y~:-J.L..i+'e.._-" is %'-k:44'~-Y~.= ~.y V }"~^~ ~yS' 4~'"y`' 1~ _ . ~^ FIOUSEKEEPING ~ ---'- ----- _.-~_.~---- . f`'h }~, ~ ,.~{ .a~ ~° ~ > _ J~, f y'"'r ----- ~---- '--'- ~ L"1 ^ FIRE PROTECTION 11 r` "fir. x•-s~.L~ . ~ f'~~ ~~; ~ 1; :7 4'' ~ _ ~ J ~ J''' ~.}~ - ... ^ SITE DIAGRAM ADEQUATE & ON HAND ._ - ANY HAZARDOUS WASTE ON SITE`: ~S ^ NO L I~ A ExPLa,IN: C-~A~S w~-'K'~"~ ' F /1C~7L S,'f /~~crc - ~ (J ~Y ~ ~~Z-U~C~ . ,. ,..., -.. QUESTIO~NS~RE~GARDING THIS INSPECTIONS PLEASE CALL US AT (881 ~ 328-3979 ---Iy4~~.d~zSL -- _.. _._----~'--------- ~----- Inspector Badge No. Business Site Responsible Party ~10~ ~"t `. White -Environmental Services Yellow • Station Copy Pink -Business Copy ; -" ti: UNIFIED PROGRAM INSPECTION CHECKLIST''. }pay.`,~~'z~`1.k',"it74,L°~F"s6.w..: ... .r tC'A~'_-fin: ~:.,k%4 .47 ~., a--. ,3>~v-,m.c9'~ -we..Y_".: ,T _..t-+..r.., ~-....e a. SECTION 1: Business Plan and Inventory Program ~` • BAKERSFIELD FIRE DEPT Prevention Services wlR~ 900 Trlixtun Ave., Suite 210 ~wrM t Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 87.2-2171 FACILITY NAME ' - ~ S 7 NSPECTION DA E O ~ INSPECTION TIME ~Ow~in - a~~JT~ L ~•vr ~1 , ~© l ADDRESS yob /~i~~ ~ . HON NO. ~3y= `~ `boo O OF EMPLOYEES FACILITY CONTACT USINESS ID NUMBER 15-021- 0 00 0o c~ eA~ Section 1: Business Plan and Inventory Program ~f -ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION L C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~/ LH . ^ BUSIft@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY 1 ~3 ~~ ,.,// ^ VERIFICATION OF INVENTORY MATERIALS l if ^ / LAS ^ 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 ~,! liid ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SIT~E~?® Q"YES ^ NO EXPLAIN: t,~AS~E ~'I_ _.- .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3879 cc Inspector (Please Print) Fire Preventio 1" In /Shift of Site/Station # Business SiteJSchoot Site Responsible Party (Please Prlnt) White -Prevention Services Yellow -Station Copy Pink - Buainesa Copy FD2049 (Rev. 02105) SAGEPOINTE DENTAL SiteID: 015-021-000008 Manager ~~ar'~'~-Vl ~t.`C'~ Location: 6405 MING AVE City BAKERSFIELD BusPhone: (661) 834-9900 Map 123 CommHaz Minimal Grid: l0A FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title WARREN BARB / PRESIDENT / Business Phone: (661) 834-9900x Business Phone: ( ) - x 24-Hour Phone (661) 834-9900x 24-Hour Phone ( ) - x Pager Phone ((P(o 1) 303 -~,2fo~x Pager Phone ( ) - x Hazmat Hazards: React Contact ~/a~-Y-~~ ~~~-- Phone: (661) 834-9900x MailAddr: P BOX 12004 State: CA City BAKERSFIELD Zip 93389 -2004 Owner DR WARREN BARRS SAGEPOINTE DENTAL Phone: (661) 834-9900x Address 6405 MING AVE 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 e:~._,.,~; ~~.~...c. ..,n ..,r,,;,;-r ;`t; !h:c 1,~,c:rr:.t:cr; ~~.,~.?~i~'.l~ar' _.n:.. ~_i!itivr.; 11721r~ior~;~,.~n ,_. ire:.IC?. ~ D ~ 1 2 ~~7 ~,: B i;G lifu i;:, xf~C.• ~;)Iil i.h c,f ~iSn~lure ~ Date -1- 02/06/2007 n F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 5.00 GAL Min -2- 02/06/2007 r ~ .: -3- 02/06/2007 • , F SAGEPOINTE DENTAL ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit DARKROOM SiteID: 015-021-000008 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS#. STATE TYPE PRESSURE Liquid TWaste ~mbient TEMPERATURE CONTAINER TYPE Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Averacte 5. 0 0 GAL /, D O GAL ~ s ~ 3 GAL tit~c~tlttUUU~ 1.V1~lYV1Vt';1V l J ~Wt. RS CAS# Silver No 7440224 ti!-~GHKL 1-~J ~7~.7~1~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/06/2007 F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/03/1999 ~ AGENCY WILL BE NOTIFIED BY FRONT DESK STAFF IN THE EVENT OF NECESSARY EVACUATION. FRONT DESK PERSONNEL WILL CALL NECESSARY 911 HELP AS INDICATED BY EMERGENCY. Employee Notif./Evacuation 09/22/2006 ALL PATIENTS AND STAFF ARE NOTIFIED PER EMERGENCY PROCEDURES. 911 IS CALLED AND NECESSARY ACTION IS TAKEN. Public Notif./Evacuation 09/22/2006 ANY STAFF MEMBER CAN ADDRESS PUBLIC FROM ANY INTERNAL PHONE LOCATION BY PUBLIC ADDRESS ON PHONE. WITH THE EXCEPTION OF CATASTROPHIC EMERGENCY, THE FRONT DESK ASSUMES THE DUTY OF PUBLIC NOTIFICATION. EXITS ARE MARKED AND CONFERRED WITH PUBLIC ADDRESS INSTRUCTIONS. Emergency Medical Plan 09/22/2006 STAFF IS INSTRUCTED TO CALL HALL AMBULANCE AT 327-4111 FOR MEDICAL EMERGENCY OR 911. -5- 02/06/2007 F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 07/25/1990 ~ TANKS OF HAZARDOUS MATERIALS ARE: CHAINED TO THE WALL, ALL FITTINGS ARE APPROVED, LINES ARE REGULATED AT THE TANK WITH APPROVED REGULATORS. Release Containment 07/25/1990 IMMEDIATELY EVACUATE ALL PERSONNEL FROM DANGER AREA. SHUT OFF LEAK IF WITHOUT RISK. VENTILATE AREA OF LEAK OR MOVE LEAKING CONTAINER TO WELL VENTILIATED AREA. Clean Up 07/25/1990 KEEP PERSONNEL AWAY. DISCARD ANY PRODUCT RESIDUE, DISPOSABLE CONTAINER, OR LINER IN AN ENVIRONMENTALLY ACCEPTABLE MANNER. ~,_ v~.sici nc~vui~.c n~.~.lva~.ivit -6- 02/06/2007 ' ~~~ ;. F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ ~ - Fast Format ~ ~ Site Emergency Factors Overall Site ~ a7~JC l:1d1 11dGdIU~S' Utility Shut-Offs 01/11/2007 A) GAS - SE CRNR OF OFFICE S OF FIRE ACCESS HALLWAY B) ELECTRICAL - MAIN PANEL MIDDLE E SIDE OF BLDG C) WATER - ATTIC DROP CEILING SW CRNR OF OFFICE ELECT SOLENOID SWITCH E SIDE S END OF CENTRAL HALL D) SPECIAL - SW END CENTRAL HALLWAY SHUT-OFF 02 •E) LOCK BOX - NO Fire Protec./Avail. Water 01/11/2007 PRIVATE FIRE PROTECTION - CLASS A, B, C, FIRE EXTINGUISHER S END OF CENTRAL HALL. SMOKE DETECTORS IN LAB AND CENTRAL HALLWAY. FIRE HYDRANT - W SIDE CHESHIRE ST OUTSIDE BLDG MIDDLE OF BLDG. Building Occupancy Level 03/10/2006 6 EMPLOYEES -7- 02/06/2007 F SAGEPOINTE DENTAL SiteID: 015-021-000008 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 09/22/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: BI-ANNUAL CPR REQUIRED FOR RDA ASSISTANTS, ANNUAL REVIEW OF MSDS SHEETS AND VCR TRAINING PRESENTATION. UNANNOUNCED EMERGENCY DRILLS. rage nClu Lur ruzure use nCiu iur ruzure use -8- 02/06/2007 :, + SAGEPOINTE DENTAL =______,~___________________________ SiteID: 015-021-000008 + Manager BusPhone: (661) 834-9900 Location: 6405 MING AVE Map 123 CommHaz Minimal City BAKERSFIELD Grid: 10A FacUnits: 1 AOV: CommCode: BFD STA 09 SIC Code: EPA Numb: DunnBrad: Emergency Contact / "7Citle Emergency Contact / Title WARREN BARB. / PRESIDENT / Business Phone: (661) 839:-9900x Business Phone: ( ) - x 24-Hour Phone (661) 834-9900x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact: _ ~ Phone: (661) 834-9900x MailAddr: PO BOX 12004 State: CA City BAKERSFIELD Zip 93389-2004 Owner DR WARREN BARRS SAGEPOINTE DENTAL Phone: (661) 834-9900x Address 6405 MING AVE State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: - Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~ PROG A - HAZMAT PROG H - HAZ WASTE GEN Based on my inquiry of those individuals responsible for obtaining the information, 1 certify under penalty of law that I have personally examined and am familiar with the information ENT BAR ~, 0 2006 submitted and believe 4he information is 4rue, accurate, and complete. ~~- ~3 -/S-O~ Signature Date -1- 03/10/2006