HomeMy WebLinkAboutBUSINESS PLAN 6/2006
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+ HEALTHSOUTH/SOUTHWEST SURGICAL ====================== SiteID: 015-021-000311 +
Manager :
Location: 201 NEW STINE RD 130
City BAKERSFIELD
BusPhone:
Map : 123
Grid: 03B
(661) 396-8900
CommHaz : High
FacUnits: 1 AOV:
CommCode: BFD STA 11 SIC Code:
EPA Numb: DunnBrad:
+==============================================================================+
+=======================================+======================================+
Emergency Contact / Title Emergency Contact / Title
LINDA BLOOMQUIST / ADMINISTRATOR SHELLEY HATCHER / SAFETY OFFICER
Business Phone: (661) 396-8900x Business Phone: (661) 396-8900x
24-Hour Phone : (661) 589-6256x 24-Hour Phone : (661) 589-6603x
~ Phone : (uCt.i) ~J\ - Q(,(rz x Pager Phone : ( ) - x
+--~U---------------------------------+--------------------__________________+
I Hazmat Hazards: Fire Press React ImmHlth DelHlth I
+------------------------------------------------------------------------------+
Contact : Phone: (661) 396-8900x
MailAddr: 201 NEW STINE RD 130 State: CA
City : BAKERSFIELD Zip : 93309
+------------------------------------------------------------------------------+
Owner HEALTHSOUTH CORP Phone: (800) 765-4772x
Address : 1 HEALTHSOUTH PKWY State: AL
City : BIRMINGHAM Zip : 35243
+--------------------------------------------------------------~---------------+
Period to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
+------------------------------------------------------------------------------+
Emergency Directives:
PROG A - HAZMAT
PROG H - HAZ WASTE GEN
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JIJN f)
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Based on my inquiry of those i.ndividua,ls
responsible for obtaining the information, I certify
under penalty of law that I have person~lIy
examined and am familiar ~ith the .info~matlOn
submitted and believe the information IS true,
accurate, and complete,
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+=======~======================================================================+
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05/30/2006
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UNIFI,ED PROGRAM INSPECTION CHECKLiSt t t
SECTION 1 Business Plan and Inventory Program
~~--~--~-~1-~---,-~----------------,--------------- 31.b~~iQ7_ ---~-~------
FACILlTYCONTACT Business 10 Number
rV 5'.)OM~VI<..T 15-021-3\(
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield. CA 93301
Section 1: Business Plan and Inventory Program
'ql Routine
D Combined
D Joint Agency
D Multi-Agency
D Complaint
D Re-inspection
C V
( C=Compliance )
V=Violation
OPERATION
COMMENTS
5f D ApPROPRIATE PERMIT ON HAND
...._,,---
rp 0 BUSINESS PLAN CONTACT INFORMATION ACCURATE
'" D VISIBLE ADDRESS
__'m''___:' __'______._~_" __"_________,,___"___'m_____h,_,,_,,
,- ",,-,,-- -, -- .,-
~ D CORRECT OCCUPANCY
-----",-,----,------------,-------,-"---,,---------,,,,-,- --'- -,,---,,-',-------, -------,,-, --,-,----,-"_.,,-,,.._-,_..,,-- --,---"--
~ 0 VERIFICATION OF INVENTORY MATERIALS
I,:J D VERIFICATION OF QUANTITIES
_______'__.._____,__________________,_,_____ __ w__________,__ __.... ,,__, _____,_.___"um_______ _,'_,,_,_,,_'_____m___'_"___'_'m"__ _,_ _ "'".,,__ ,__ ,,_
. .9__~____~~_R~~:ATIO~ OF _~OC~~I~~_______________________ _____________________ _..._________________ _____ _____ ___ _"
~ D PROPER SEGREGATION OF MATERIAL
~___,.~_~___~___.____~______._.___ .___.___.__..______.____".._....__.__._ _. .___.".________.__._ '..__n._..__+_ ~_ . .... _..~_____.___...___,_. ___.___ _____. _..____. __<_
M.__~__~=RIFI:~TION OF ~_~~~~~~L~~~~:':':':____.__h___.._' ___._ _ ________________.__ __ __ ._'..__,_'_____'__n ______m _.m._____ ___
iB D VERIFICATION OF HAT MAT TRAINING
__'_____.__,____,____________,_,_,_________ ..___on, ______, _'_n________ n ___n_'______"'_ _ .n_______,__"_ __ _ __ ,,_n___ ._
$I D VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
- ---'----------__________________",_______,___________ ,_.o____ ___,_,_._,____________"",_ __n'n_'__'_' _,_'_ ,,__, _____,,_____... ,_n__._______ _ _h_""
~_~-:~::::~-:::~~E~;~~UA~--- _ _ t_u u _u_, _ _ u _ _ ,
-- - ------ -- -- _ ___ ___ ___ _____ ___ _n_ _____ ____ _ __ ~_ ____ __ _____ ___ _ __ _...._ _ _ _ __"uh,_______,_____,,_,___,_,
~ D HOUSEKEEPING. 1
-- ______'_~__.__________________u___________.____._____ '..._." ___'_n___ ___ _____"__.______..___.__.__..___ .. ____________._,."._______. _ _ ,_, _.____ ~._' ___no. .___.__.__.._
ItI D FIRE PROTECTION
--~---O---SI~;o~~~~~MA~~~~~~~-&nON--H~~~------- -------,---- -,------- --- ---"'----,---------------- .. - -- ____.___u_. ..... - --- -- ----
I
ANY HAZARDOUS WASTE ON SITE?:
DYES
JQNO
EXPLAIN:
.
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
-~~- -~~~1 NO~---u- ' ~---
White - Environmental Services
Yellow - Slalio~ Copy
Pink .. Busi~ess Copy
CITY OF BAKERSFIEIJD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
1/';J7/C/~
PHONE NO. JY6" c;P7,c;)O
BUSINESS ID NO. 15-210- C::OZJ..?//
NUMBER OF EMPLOYEES /S-
FACILITY NAME A'6/"7'~..( v&~
ADDRESS pe:;;/ ~~ lJ7".I/L1(:-' .,/...70
FACILITY CONTACT L//lJiB19- /j/dCJ"l;~
INSPECTION TIME /S"OO /Jas. '
INSPECTION DATE
Section 1:
;i.. Routine
Business Plan and Inventory Program
o Combined
D Joint Agency
o Multi-Agency
D Complaint
D Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand '-
Business plan contact information accurate L...-
Visible address "-
Correct occupancy L-
Verification of inventory materials '-
Verification of quantities '-
Veri fication of location '-
Proper segregation of material t-
Verification of MSDS availability I..-
Verification of Haz Mat training t-
Verification of abatement supplies and procedures /
'"'-
Emergency procedures adequate /
Containers properly labeled ~
Housekeeping '-
Fire Protection L-
Site Diagram Adequate & On Hand L .-'
C=Compliance
V=Violation
Any hazardous waste on site?:
Explain:
DYes JtrNo
~
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env, Svcs,
Yellow. Station Copy
Pink. Business Copy
sponsible Party
Inspector: {71..4; c7: ~ / /-ft
~.