Loading...
HomeMy WebLinkAboutBUSINESS PLAN" ~ i' AKAD ORTHODONTIST ii 6409 MING AVENUE _ - , UNIF~D PROGRAM INSPECTION CHECKLIST A_ _~._ SECTION 1: Business Plan and Inventory Program - Prevention Services B ~ FRS "~ , n 900 Truxtun Ave., Suite 210 FARE Bakersfield, CA 93301 D ARTM Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME (~ 1L pep O 2'T t~ o .D O ~ ~- ) d O ADDRESS ~ "" - - b 1 ~ g hrt ~ PFJ_O' NO^ ~ ~M 8 S 1'Ii W NO OF EMPLOYEES ~ ~ ~ - , ,~ G FACILITY CONTACT ~ BUSINESS ID NUMBER 15-021=p~5^dy/ Section 1: Btasiness Plan and Inventory Program ..y4_ __ -- - - ^ ROUTINE ~ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPE"RATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIni3SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS , ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS `~ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~1 ^ PROPER SEGREGATION OF MATERIAL ' ~~~ ^ VERIFICATION OF MSDS AVAILABILITY ~ `' `~ ^ VERIFICATION OF HAZ MAT TRAINING ~^r ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~© ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING CJ ~ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ~2~t ANY HAZARDOUS WASTE ON SITE? ,AYES ^ NO EXPLAIN: ~ ~ czS~c ..~-.~ ~~ Q//U+~ESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326.3979 ` Inspector (Please Print) Fire Prevention / 1~' In /Shift of Site/Station # t3~i ries I {Y~s ons Par (<<BI e White -Prevention Services - " Yellow -Station Copy Pink - Busihess Copy - FD 2155. (Rev. 09/05 y0~y`" _`rc~°~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~~ OFFICE OF ENVIRONMENTAL SERVICES sn . ~ ~~ UNIFIED PROGRAM INSPECTION CHECKLIST °.~~ ~~~~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME ~ ~ ~ ~ R-'~`I~ a ~ o ~y-s' ~s -t- INSPECTION DATE ~ / ~d ~o ~ Section 4: I~azardous Waste Generator Program EPA ID # ~x~~'`-&' ~ ^ Routine ~ Combined ^ Joint Agency ^hulti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~ X £;.~,.,~-~-- 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 ~ ~ Proper management of used oil filters ~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC ~ -- R.P y S v~ ,~-~~ ~, ~, 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 ~=~ompitance v=vto-anon Inspector: ~ 9 G~~A- ~/ Office of Environmental Services (661) 326-3979 White -Env. Svcs. Pink -Business Copy Bus ness ite es tb y AKAD ORTHODONTIST Manager DEBBIE BOLOSAN Location: 6409 MING AVE City. BAKERSFIELD CommCode: BFD STA 09 EPA Numb: SiteID: 015-021-002316 BusPhone: (661) 834-4100 Map 123. CommHaz Minimal Grid: l0A FacUnits: 1 AOV: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title DEBBIE BOLOSAN / OFFICE MANAGER AMANDA TORRIGIANI / RDA Business Phone: (661) 834-4100x Business Phone: (661) 834-4100x 24-Hour Phone (661) 204-0195x 24-Hour Phone (661) 204-0194x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact BAKER AKAD ~ Phone: (661) '834-4100x MailAddr: 6409 MING AVE State: CA City BAKERSFIELD Zip 93309 Owner BAKER AKAD Phone: (661) 834-4100x Address 6409 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 _ - _ ~~0 F _ ._ . _ F~ E3ased on my inquiry of those individuals ~ ~ ~ responsible far obtaining the information, I certify QO, under penalty of law that I have personally examined and am familiar with the information submitted nd believe the information is true, ac rat a omplete. na to -1- 01/24/2007 _ // v!'. + AKAD ORTHODONTIST ___________________________________ SiteID: 015-021-002316 + Manager BusPhone: (661) 834-4100 Location: 6409 MING AVE Map 123 CommHaz Minimal City BAKERSFIELD Grid: l0A FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title DEBBIE BOLOSAN / OFFICE MANAGER AMANDA TORRIGIANI / RDA Business Phone: (661) 834-4100x Business Phone: (661) 834-4100x 24-Hour Phone (661)-I'78x Zt?~(^o 24-Hour Phone (661) q Pager Phone ( ) ~' ~ `~ ~ ° t `~~~ Pager Phone ( ) - x Hazmat Hazards: React _ ' _ `- _ - - Contact Phone : ( x ) - MailAddr: 6409 MING AVE State: CA City BAKERSFIELD Zip 93309 Owner BAKER AKAD Phone: (661) 834-4100x Address 6409 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 1 ~' l Q ~ ' ~~ ~~~ J ~ 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, ac ur , a .d complete. r at r `~ l ~-~ a ~~`D`g ~ y`;~ ENrD JUG 2 5 ~®p~ t______________________________________________________________________________+ -1- 05/15/2006