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HomeMy WebLinkAboutBUSINESS PLANNEZAM BEHESHTI DMD 6663 NIING AVENUE :> BEHESHTI DMD NEZAM SiteID: 015-021-002985 Manager NEZAM BEHESHTI DMD Location: 6663 MING AVE City BAKERSFIELD BusPhone: (661) 831-0800 Map 123 CommHaz Minimal Grid: l0A FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title NEZAM BEHESHTI DMD / OWNER / Business Phone: (661) 831-0800x Business Phone: ( ) - x 24-Hour Phone (661) 627-0159x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact NEZAM BEHESHTI DMD Phone: (661) 831-0800x MailAddr: 6663 MING AVE State: CA City BAKERSFIELD Zip 93309 Owner NEZAM BEHESHTI DMD Phone: (661) 831-0800x Address 6663 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 ~A~~ I' y '0 ~U~ e 1 pA+~ i~ ~4~U/ t3ased on my inquiry of those individuals responsible far obtaining the information, I certify under penalty of iaw that I have personally e xamined and am familiar with the information submitted and believe the inf ormation is true, accurate, and complete. '~ , 7 ~7 O7 Si gnature Date -1- 07/09/2007 F BEHESHTI DMD NEZAM SiteID: 015-021-002985 ~ ~ 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 7.00 GAL Min -2- 07/09/2007 -3- 07/09/2007 F BEHESHTI DMD NEZAM SiteID: 015-021-002985 ~ ~ 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 -~LASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 7.00 GAL 7.00 GAL 7.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# Silver No 7440224 tit~G.'~ttL r~aa~~~ri~lvl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/09/2007 ,~, , F BEHESHTI DMD NEZAM SiteID: 015-021-002985 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ r_ tly Gill. ~/ 1VV 1..1111..0. V1V11 Employee Notif./Evacuation 01/23/2006 EVERYONE IS TO GO OUTSIDE OFFICE. ru.u111: 1VVl.1t . / GVdUUdl.lCJil Emergency Medical Plan 01/23/2006 WE HAVE AN EMERGENCY KIT WITH UPDATED MEDICATIONS AS WELL AS OXYGEN TANK WITH MASK, AND WE ARE INSTRUCTED TO CALL 911. -5- 07/09/2007 F BEHESHTI DMD NEZAM SiteID: 015-021-002985 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ _, a~cicaoc ricvcii~..ivii Release Containment 10/11/2006 HAZARDOUS MATERIALS ARE KEPT IN CONTAINERS AND WE HAVE AN AGENT WHO COMES AND PICKS UP ALL THE HAZARDOUS WASTE WHEN NECESSARY. __ Clean Up 10/11/2006 'IAF1~A'NY FIXER OR DEVELOPER SPILLS, IT .NEEDS TO BE CLEANED UP IMMEDIATELY. V~~C., ~ Ci~Q. f m ~~ u~,~5 ~Gt, r~ ~ ~ ~ ~ ~ ~ ~ ~~~2 v ~v~ ~" ~l kS Vv Vi, ~~ h o~ r 2, ~ l~.c~.d ~~ Se~OUr~.~ ~-,~ s . V1.11C1 t~CSC~uic;~ .~.c:~lvazion -6- 07/09/2007 F BEHESHTI DMD NEZAM SiteID: 015-021-002985 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aNc~.s.a~. nac.al.u~ Utility Shut-Offs 01/26/2007 NO GAS LINE AND WATER LINE IS TAKEN CARE OF BY BLDG MGR. ----- Fire Protec./Avail. Water 04/11/2007 SPRINKLER SYSTEM AND FIRE EXTINGUISHER IN WAITING ROOM AND BACK OFFICE. Building Occupancy Level 01/23/2006 3 EMPLOYEES -7- 07/09/2007 F,BEHESHTI DMD NEZAM SiteID: 015-021-002985 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/26/2007 ~ SAFETY MANUAL (SAFETY COMPLIANCE SERVICES) BINDER IN OFFICE. rayc ~ nclu tvi ruI.ULC 115C L1C 1C1 lUZ 1"UI.UL E'' USe -8- 07/09/2007 ~-.~ . ' =~ J1~ezam Bekeskti, D.9Vf.D. General Dentistry - i '3' - -= ~ ~ - .,' ~ ~~- ®o© 6663 Ming Ave. • Bakersfield, CA 93309 Tel: (661) 831-0800 Fax: (661)831-4994 l + BEHESHTI DMD NEZAM =____=~___________________________ SiteID: 015-021-002985 + Manager NEZAM BEHESHTI DMD Location: 6663 MING AVE City BAKERSFIELD BusPhone: (661) 831-0800 Map :.123 CommHaz Minimal Grid: l0A FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / "~."itle Emergency Contact / Title NEZAM BEHESHTI DMD / OWNER / Business Phone: (661) 831-0800x Business Phone: ( ) - x 24-Hour Phone (661) 627-0159x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact NEZAM BEHESHTI DMD Phone: (661) 831-0800x .MailAddr: 6663 MING AVE State: CA City BAKERSFIELD Zip 93309 Owner NEZAM BEHESHTI DMD Phone: (661) 831-0800x Address 6663 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 EN~`D ~tiA ~ ~ 1206 8esed on my inquiry of those individuals responsible far obtaining the information, I certify under penalty of law that f have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~.: ~, 3/1 ~ /o C~ Signature Date -1- 03/10/2006 s Jf~ ._ ~ lN~ ° T'~ Bakersfield Fire Dept. UNIFIED PROG~IVI INSPECTION CHECa4LIST ~ Eniron~nental Services __ _ - -~- ~-, .. ~ ,;~ . _ :' 1715 Chester Ave SECTION 1 Business Plan and Inventory Program ~ Bakersfield, CA 93301 2~ ~'~ ~ Tel: (661)326-39'f$'~ qp c FACILITY NAME INSPECTI N DA E INSPECTION TIME L~pJ ADDRESS PHONE No. No. of Employees --=-3----~tnJ~q-----__. ~_ ----------- ---------------- ------------_--- FACILITYCONTACT ~ Business ID Number 15-0 - NC~ Section 1: Business Plan and Inventory Program ~c iZ~~s' O Routine Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re- C y nce ~ oPEI~T~®N ti l V=Vio a on ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY COMMENTS 1 ~;~'V ~ ^ ^ ~ VERIFICATION OF INVENTORY MATERIALS W ~S~ ~ ~1L ^ ^ VERIFICATION OF QUANTITIES /~~ ^ ^ VERIFICATION OF LOCATION (NS ~~C ~/~f~~+ . ~~ ^ ^ 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 - ^ -- ^ --------- --------- ---- -- -----.. _ _ _ - -- t HOUSEKEEPING 1 -- ------- -------------------------- ^ ^ FIRE PROTECTION ~ ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ~.f~1 - - ~~i~ ~s°c~l_. ~i_Eiksc LIZ 1.4a~s Wu~^,'r~ ANY HAZARDOUS WASTE ON SITE?: id"'T ES ^ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) F e Prevention 1st-In(Shitt of Site B ~ ess Site Responsible Party (Please Prin N White -Environmental Services Yellow -Station Copy Pink -Business Copy ~~'~~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~ OFFICE OF ENVIRONMENTAL SERVICES y UNIFIED PROGRA1dI INSPECTION CHECKLIST ~k•E"' Agti 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME /~Z~t^'I ~~eS~'r! 7~ INSPECTION DATE ~f { 4 r~ Section 4: Hazardous Waste Generator Program EPA ID # 'J/~ ^ Routine /~ 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 ~~~ ~(~j1/~nL~ 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 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 ~-wu,puiu,cc v = v ~aaaon / y Inspector ~ ! ~~~ (/ D Office of Environmental Services (661) 326-3979 Business Site Responsi.b e y White -Env. Svcs. Pink - Businoss Copy ,,~'~~ - - ^ CITY Or ~AI{ERSFIELD B E R s P ` ° OFFICE OF ENVIRONMENTAL SERVICES ~ € ~~ F/R®' Ali<TM T 1715 Chester Ave., CA 93301 (661) 326-3979 - +t'u~".. ~uew .~~~~~e HAZARDOUS MATERIALS INVENTORY ~ CHEMICAL DESCRIPTION (one )orm per material per building orarea) [~ ^ ADD ~ ^ DELETE ^ REVISE 200 Page _ of _ I__- 4 ,-- _ `-____._µ~__ . ...____ ._ _..__.__...... _._ I. FACILITY INFORMATION -- -__- .._._.__ ._ _ -- .. ---..... _ a BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) ~ 3 '~ W ~'Z.~-/vl ~ ~-~-5 if i 1 ~ ~ ~ -- - - -- - CHEMICAL LOCATION ~ 201 CHEtAICAL LOCATION ^ Yes ^ No 202 i f~~ t Ot= ~/Yl.(C 4~ CONFIDENTIAL (EPCRA) ~ _ _ _ _ ~. - A LITY ID # ( ~ 1 MAP # (optionaq 203 - GRID # (optionaq 204 i ~ .-I I r-- " - . .... ~-_..__ ~_._f_- ~ -- ~-- L..._-_--"I- ------~ _._.....__..--..____.-__.._-_ ..__- _.___-__ ~ . ,. II. CHEMICAL ItFORMATION CHEMICAL NAME 205 TRADE SECRET ^ Yes ^ No 206 .' r~ ~ L ~f }~~ ~ i If Subject to EPCRA. refer to instructions - i -- - - - -- --I- - ----- COMMON NAME CAS # FIRE CODE HAZARD CLASS TYPE PHYSICAL STATE FED HAZARD CATEGORIES (Check all that apply) ANNUAL WASTE AMOUNT STORAGE CONTAINER (Check all that apply) STORAGE PRESSURE STORAGE TEMPERATURE 207 i EHS' ^ Yes ^ No 208 j -.. 209 ;~ •If EHS is'Yes,? all amounts below must be in _ lbs. ES (Complete if requested by local fire chief) i 210 ~ ` . -. - -- - - - ------- -------- -- - - - -- - -__ .- _c ^ p PURE ^ m MIXTURE w WAS i _ . _ .. - _ . -- - - - R-~DIOACTIVE ^ Yes ^ No 212 ~ CURIES 213 ^ sSOLID ~t`QUID ^ 9 GAg 214 LARGEST CONTAINER ~ 215 j ^ 1 FIRE ^ 2 REACTIVE ^ 3 PRtSSJRE RELEi,SE ^ 4 ACUTE HEALTH ~:p CHRONIC HEALTH 216 217 w14XIML'ht ! DAILY AMOUNT ? 218 AVERAGE 219 j STATE WASTE CODE ~ DAILY AMOUNT ? I 220 i ~ UNITS' ~a GAL ^ d CU FT ^ Ib LBS ^ to TONS 221 ~ DAYS ON SITE 222 '• If EHS, amount must be in lbs. ~ ^ a ABOVEGROUND TANK ~ PLASTIC/NONMETALLIC DRU M ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 ^ b UNDERGROUND TANK ^ f CAN ^ j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN ^ d STEEL DRUM ^ h SILO ^ I CYLINDER ^ p TANK WAGON ,-~{ ,P~J a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT i 224 ~ q~.AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 ~%WT _~ ~ ~' NA711RDOUS COMPONENT EHS i ' CAS #` ~ I ~ ~ - 7 1 i 226 227 I ^ No 228 - 229 ~ ^ Yes 1 2 230 i 231 I I 233 i -- i ^ Yes ^ No 232 ' 3 ~ 234 235 ~-^-^ Yes ^ No 236 ~ _ ------ 237 i i 4 238 1 239 i ^ Yes ^ No 240 241 -1-- .------ _ _ _ - -------- _ _ - -- _ -------- 5 242 243 ^ Yes ^ No 244 i 245 j I .____ll_ UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd UNIFIED PROGRAM INSPECTION CHECKLIST ?€_~' '"}C.: .h^5.'8?'b„v"a ::[..~.. ...,.. y_.._..,_y ,t -a .. uf. ., 'n, ..: -1'. fi'-,., ..„y. :.u3?.: SECTION 1: Business Plan and Inventory Program ~ Tel.: (661) 326-3979 • Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE INSPECTION TIME ADDRESS HONE NO O OF EMP QYEES !o i a! ~i vc ~ ^ O ~v~ 8JQ FACILITY CONTACT USINESS ID NUMBER 248' ~s-o21- 00 E z M ~EN r£sH'r" . Section 1: Business Plan and Inventory Program ~ ~~~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION r~ L_J C V ~ C=Compliance OPERATION V=Violation COMMENTS __ ~~// ^ le 7 APPROPRIATE PERMIT ON HAND - / ^ G d~ BUSIr18SS PLAN CONTACT INFORMATION ACCURATE ~~ // Ly' ^ VISIBLE ADDRESS L[!' ^ CORRECT OCCUPANCY L~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES --// L~ ^ VERIFICATION OF LOCATION ~A/~ I r , L'l ^ PROPER SEGREGATION OF MATERIAL z 9 +~ . ^ VERIFICATION OF MSDS AVAILABILITY Ld' ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES Cf ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION G~ ^ SITE DIAGRAM ADEQUATE ~ ON HAND ANY HAZARDOUS WASTE ON SITE? LN'YE$ ^ NO EXPLAIN: L/~~~ ~ ~l~_~3^'~- _~__ .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-387f>f Q tc.i,tf KD88~~'S Inspector (Please Print) Fire Prevention / 18' In /Shift of Site/Station p BAKER3FIELD FIRE DEPT Prevention Services r~w~ 900 Tnixtun Ave., Suite 210 ~wrlr r Bakersfield, CA 93301 White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02/05) ~~~~( r ~'~ UNf~IED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program Prevention Services B A FRS,: , , „ 900 Truxtun Ave., Suite 210 FiR,F Bakersfield, CA 93301 ARTM Tel.: (661) 326-3979 Fax: -(661) 872-2171 ~'~. FACILITY NAME ~ Ij G 5 INSPEC ION DATE ~ INSPECTION TIME 1 C ~CTt ~/hJ7 ~ a~o ~' ADDRESS b 6b 3 PHONE NO. ~3i ~ o~ NO OF EM LOYEES - M~>u~ ~v~c FACILITY CONTACT BUSINESS ID NUMBER 15-021 {~ I s ' O?~ 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 ^ BUSIfteSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ~N. -T-',p ~. ^ VERIFICATION OF INVENTORY MATERIALS _ s - n ~~! ®, ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL ~~® VERIFICATION OF MSDS AVAILABILITY ~~ ~~T(~ rns ~~ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION S2Tv~~L ~~~~/-C ~XT~n j ~~ ^ SITE DIAGRAM ADEQUATE & ON HAND G /v~ ANY HAZARD`OU^S WA~Sj.TE ON~S'?ITE? YES ^ NO EXPLAIN: `~ ~ 5 `Q '~ l k G :~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 G~~~~a~s Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # White -Prevention Services - Yellow -Station Copy Pink -Business-Copy FD 2155 (Rev. 09/05 ~~~°~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~~ OFFICE OF ENVIRONMENTAL SERVICES ~t~ UNIFIED PROGRAM INSPECTION CHECKLIST ,k~,"' ;g~w~~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 9330fl FACILITY NAME t5 C t-1 C s+j i ~ D /-~~ INSPECTION DATE ~ /~a~o ~ Section 4: Hazardous Waste Generator Program EPA ID # ~X~ ~^-~ t'- ^ Routine [~ Combined ^ Joint Agency ^Muiti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~~C yr,•-~ PT Authorized for waste treatment and/or storage Reported release, fire, or explosion within I S 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 N Secondary containment provided ~e, u, ~~ c ~~Go~ ~ ~.~ CU Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste N/ 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 ~q~ ¢+ Sar+ Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years A.J ~ Determines if waste is restricted from land disposal C=Compliance V=Vinlatinn /l :,, ...- fi Inspector: ~ ~~~-~-1 ~--J Office of Environmental Services (661) 326-3979 'Business Site Responsible art White -Env. Svcs. Pink -Business Copy u BEHESHTI DMD NEZAM SiteID: 015-021-002985 Manager NEZAM BEHESHTI DMD Location: 6663 MING AVE City BAKERSFIELD BusPhone: (661) 831-0800 Map 123 CommHaz Minimal Grid: 10A FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title NEZAM BEHESHTI DMD / OWNER / Business Phane: (661) 831-0800x Business Phone: ( ) - x 24-Hour Phone (661) 627-0159x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact NEZAM BEHESHTI DMD Phone: (661) 831-0800x MailAddr: 6663 MING AVE State: CA City BAKERSFIELD Zip 93309 ............... Owner NEZAM BEHESHTI DMD Phone: (661) 831-0800x Address 6663 MING AVE State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUST,s: _ ~ Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ENT F ~ ~ 2 ~ ~~0~' 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 submitted and believe the information is true, accurate, and complete. , ! 6 Signature Date . -1- ~ O1/26/2b07 F BEHESHTI DMD NEZAM = ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-002985 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 7. 0 0 GAL 1~+In I -2- 01/26/2007 -3- O1/26/2b07 F BEHESHTI DMD NEZAM ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit DARKROOM SiteID: 015-021-00295 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste ~ Ambient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 7.00 GAL 7.00 GAL 7.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# Silver No 7440224 rita~r~tcL r~a5~5ain.~iv~1~~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Miff -4- 01/26/2007 ~ F BEHESHTI DMD NEZAM SiteID: 015-021-00295 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification Employee Notif./Evacuation O1/23/20d6 EVERYONE IS TO GO OUTSIDE OFFICE. r ILJJ 1 1 1. 1V V 1.. 1 1 .~ 1J V Gi \.. UGL V 1 V l l Emergency Medical Plan O1/23/20d6 WE HAVE AN EMERGENCY KIT WITH UPDATED MEDICATIONS AS WELL AS OXYGEN TANK WITH MASK, AND WE ARE INSTRUCTED TO CALL 911. -5-" Ol/26/2b07 F BEHESHTI DMD NEZAM SiteID: 015-021-00295 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Sits ~ ~ Release Prevention Release Containment 10/11/20t~6 HAZARDOUS MATERIALS ARE KEPT IN CONTAINERS AND WE HAVE AN AGENT WHO COMES AND PICKS UP ALL THE HAZARDOUS WASTE WHEN NECESSARY. Clean Up 10/11/20E~5 IF ANY FIXER OR DEVELOPER SPILLS, IT NEEDS TO BE CLEANED UP IMMEDIATELY. Other Resource Activation -6- O1/26/2b07 • . F BEHESHTI DMD NEZAM SiteID: 015-021-00295 ~ Fast Forme:t ~ ~ Site Emergency Factors Overall Site ~ Special Hazards Utility Shut-Offs 01/26/20177 NO GAS LINE AND WATER LINE IS TAKEN CARE OF BY BLDG MGR. Fire Protec./Avail. Water O1/26/20t~7 FIRE EXTINGUISHER IN WAITING ROOM AND ONE IN BACK OF OFFICE. Building Occupancy Level O1/23/20E76 3 EMPLOYEES -7- O1/26/2i~07 l~ S ~ F P BEHESHTI DMD NEZAM SiteID: 015-021-00295 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training O1/26/20C77 ~ SAFETY MANUAL (SAFETY COMPLIANCE SERVICES) BINDER IN OFFICE. rayc c. Held for Future Use neia =or ruzure use -8- Ol/26/~007