The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN 7/28/2007II i, CHARLES 1VI. LEE I, C ~~ 9000 MING AVE., #T-2 ~ I --- - - /. ,,, .r LEE DDS INC CHARLES M SiteID: 015-021-002249 Manager JULIE LEE Location: 9000 MING AVE T-2 City BAKERSFIELD BusPhone: (661) 663-8687 Map 123 CommHaz Minimal Grid: 05C FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title OLIVIA GONZALEZ / DENTAL ASST / Business Phone: (661) 663-8687x Business Phone: ~( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact JULIE LEE Phone: (661) 663-8687x MailAddr: 9000 MING AVE T-2 State: CA City BAKERSFIELD Zip 93311 Owner CHARLES M LEE DDS Phone: (661) 663-8687x Address 9000 MING AVE T-2 State: CA City BAKERSFIELD Zip 93311 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif~d: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ENr°®~u~ o~ ~ oo~ C3ased on my inc;uiry of those indi~~iduals respcnsib~e~ `or obtaining the information, !certify under penalty of la~v that I have personally ' snformatlon examined and am familiar with the submitted and believe the information is true, accurate, and complete. Cf~--- ~ ---- 1 L6 v~"_ Signature - Date -1- 07/12/2007 F LEE DDS INC CHARLES M ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-002249 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 1.00 QT Min -2- 07/12/2007 -3- 07/12/2007 r. ~ F LEE DDS INC CHARLES M ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit LAB RM SiteID: 015-021-002249 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# Liquid TWaste ~ Ambient~E ~ AmbientT~E -~STOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 QT 1.00 QT 1.00 QT rlt~~r~tcl~vu5 ~;~l~iruiv~lvl a $Wt. RS CAS# Silver No 7440224 riE~GHKL A~7L" 7J1~1t51V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/12/2007 r. F LEE DDS INC CHARLES M SiteID: 015-021-002249 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/11/2007 ~ 911 Employee Notif./Evacuation 04/11/2007 VERBAL NOTIFICATION. EVACUATION THROUGH FRONT OR BACK DOORS. Public Notif./Evacuation VERBAL NOTIFICATION. EVACUATION THROUGH FRONT OR BACK DOORS. 04/11/2007 Luiciycii~.Y i•acui~..ai rlaii -5- 07/12/2007 F LEE DD5 INC CHARLES M SiteID: 015-021-002249 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention Release Containment 04/11/2007 SECONDARY CONTAINMENT Clean Up 04/11/2007 PAPER TOWELS AND CALL PATTERSON DENTAL. ~,_ V 1..i1G1 iCG.7VLL1 l~G riVl.1V0.l.1 Vll -6- 07/12/2007 ;~ F LEE DDS INC CHARLES M SiteID: 015-021-002249 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~7NCC:ld1 rid'Gc11(15 Utility Shut-Offs 04/11/2007 GAS - REAR OF BLDG ELECTRICAL - REAR OF BLDG WATER - REAR OF BLDG Fire Protec./Avail. Water SPRINKLER SYSTEM AND FIRE EXTINGUISHERS 04/11/2007 Building Occupancy Level 04/11/2007 4 EMPLOYEES -7- 07/12/2007 F LEE DDS INC CHARLES M SiteID: 015-021-002249 ~ Fast Format ~ ~ Training Overall Site ~ L'lll~J1V1lCC 1L CL 111il1y t'dyC G Held for Future Use rac~..u ivi r u~.uic vac -8- 07/12/2007 _- ~~3~ ~" _ ._r - Prevention Services UNIFIED PROGRAM INSPECTION CHECKLFST' R F R s e , ,, 900Truxtun Ave., suite 210 - Free Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program "RrM T Tel.: (661) 32, 6-39?9 J~,~NN Fax: (661) 872-2171 FACILITY NAME ~.~~ Q~S INSPECTION DATE ~o(~~ INSPECTION TIME ADDRESS ~ OO l ~ , „ ~ ~ ~ b ~_ ~ V P ~ ~~0. ~~ NO OF EMP .OYEES - FACILITY CONTACT BUSINESS ID NUMBER 15-021-0 l S °021-~ _. - - - _ - Section 1: Business Plan and Inventory-Program " ~____ ~ - ^ ' RE-INSPECTION ^ ROUTINE LI~ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT C V ( C=Compliance OPERATION V=Violation GOMMENTS ^~ APPROPRIATE PERMIT ON HAND ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS , ^ 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 ^~ FIRE PROTECTION 1 Q,~ /~t~ ~~CV ; G ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ~~ YES EXPLAIN: ~ ?~S"Y"C' ~ i X'E~~' QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US A7 (661) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # Busi ite / Re p n le Party (Ple se Print) ^ NO x~ White -.Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ~,~ ~'U ~ ~~ ~ r ~~'~ ~° ~g~ `~~~4`tiLD Fj~~`~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~`~ ~~ OFFICE OF ENVIRONMENTAL SERVICES ~~' , ~~ UNIFIED PROGRAM INSPECTION CHECKLIST °.~~~~~ 1'715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME L ~ ~ D 17 S INSPECTION DATE ~' / / a /o, Section 4: Hazardous Waste Generator Program ^ Routine ~ Combined ^ Joint Agency EPA ID # ~i rc ~ r^^ ~ t' ^ Multi-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 E°-~=~ '~""" 1 '°~' p'6""" ~ Containers are compatible with the hazardous waste e Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line /d Secondary containment provided ~ ~~ ~ ,, ~o .~ ~ JV.~a o. n- n ~ w-.. 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 1'~ l~, Transports hazardous waste with completed manifest Sends manifest copies to DTSC ~ ~~o,,.~ 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 =~ompnance v=vtotanon Inspector: ~r'~~~~-~- -~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. ~ ~-~r sin ss Site Res onsible Party Pink -Business Copy ~~; . ~T LEE DDS INC CHARLES M Manager ~"u,(ie.. Lee. Location: 9000 MING AVE T-2~ City BAKERSFIELD SiteID: 015-021-002249 BusPhone: (661) 663-8687 Map 123 CommHaz Minimal Grid: 05C FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergenc Contact / ~T~'jtl ~, Business Phone: (661) 663-8687x Business Phone: ((~~ ) (obj -g(~~"x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact ~~_~<.- 'LCeG _ Phone: _.(661) 663-8687x MailAddr: 9000 MING AVE T-2 State: CA City BAKERSFIELD Zip 93311 Owner ~ ~,Wy (.gyp het- Phone :( 6 61) 6 6 3- 8 6 8 7 x Address 9 0 MING AVE T-2 State: CA City BAKERSFIELD Zip 93311 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~N ~-~~ z ~ ~®®p Based on my inquiry of those ind'+viduals nsible for obtaining the information, (certify respo 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. G~-~... 2~_~ -1 ' `~~ Signature Date -1- 02/02(2007 1~ F LEE DDS INC CHARLES M SiteID: 015-021-002249 ~ ~ 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 1.00 QT Min -2- 02/02/2007 '3- 02/02/2007 ._ ; F LEE DDS' INC CHARLES M SiteID: 015-021-002249 ~ ~ 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: TSAR RM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 QT 1.00 QT 1.00 QT HAZARDOUS COMPONENTS oWt. RS CAS# Silver No 7440224 rltiGrittL H. 7.7r,J.71~1L' 1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/02/2007 i F LEE DDS INC CHARLES M SiteID: 015-021-002249 ~ Fast Format ~ F= Notif./Evacuation/Medical Overall Site ~ riyC11~:~/ lVV1.1111:d1.1V11 Employee Notif./Evacuation = ,_ , .r r U1J 1 1 V 1V V 1.. 1 1. ~~ V 0.l. U 0. l.. l V l l PrillCLt~C11C: ~/ 1"1Cll1l:d1 Y1d11 -5- 02/02/2007 a F LEE DDS INC CHARLES M SiteID: 015-021-002249 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention xelease ~on~ainmenL = ~:iean up Other Resource Activation -6- 02/02/200 F LEE DDS INC CHARLES M SiteID: 015-021-002249 ~ Fast Format ~ ~ Site Emergency Factors Overall Site. ~Yc~ia.~ na~al.u5 ~~iii~y allu~.-vl.l.~ ~_ r il..c rl.v~.c~ . / r~Vai.L wat.ci -- - - _ ~ DU11ti.l lll~. VI: C; LL~J CLIIC: ~/ LCVC1 -7- 02/02/2007 ~~ 4 F LEE DDS INC CHARLES M SiteID: 015-021-002249 ~ Fast Format ~ ~ Training Overall Site ~ employee 'training ra.y c ~ nciu tv.~ r u~uic vac raciu ivi. r u~.utc vac -8- 02/02/2007 FACILITY NAME ADDRESS /7 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY CONTACT INSPECTION TIME Section 1: Business Plan and Inventory Program INSPECTION DATE '"'~/"50/¢! PHONE NO. BUSINESS IDNO. 15-210- /,-~--~ NUMBER OF EMPLOYEES 'Z~ Routine ,~.Combined [~ Joint Agency [~ Multi-Agency ~ Complaint q Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials 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 Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: .Explain: ~n'~z ~°{~'CO Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Business Site Responsible Inspector: ~/~ CHARLES M. LEE D.D.S. Family & Cosmetic Dental Care 9000 Ming Avenue Suite T-2 Bakersfield, CA 93311 At The Market Place North Of Rite Aid (661) 663-8687 CHARLES M. LEE D.D.S. MARISELA HERRERA R.D.A. Family & Cosmetic Dental Care 9000 Ming Avenue, Suite T-2 Bakersfield~ CA 93311 At The Market Place North Of Rite Aid (661) 663-8687 Appointment Reminder For:_ On: Mon. Tues. Wed. Thurs. FrL Sat. _at_~AM/PM if you are unable to keep your appointment, please let us know at least 24-hours in advance so that we may schedule another patient and reschedule your appointment. For:_ Appointment Reminder On: Mon. Tues. Wed, Thurs, FrL Sat. at AM/PM you are unable to keep your appointment, please tel us know at least 24-hours in advance so that we may schedule another patient and reschedule your appointment. FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 INSPECTION DATE '7/5c)/~1 Section 4: Hazardous Waste Generator Program EPA ID # [] Routine ~ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made ,~(..C ¢ 'T'~"~5 0/~.. EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) 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 ~--c f::: f_~o-.,d'r'/'-,-~C,.~'-~ ~ ~x./t ~ 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 C=Compliance V=Violation Inspector: Office of Environmental' Services (661) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy