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Home My WebLink AboutBUSINESS PLAN // \ ~ stOCKDALE VET ~OS.p.ITAL. \. 6400 NOTT~GHAM L~E ~-,-""J \ /,~, ~: _..~~.;'" 1"111- 'i :t STOCKDALE VETERINARY HOSPITAL Manager : GAYLYN MOSS Location: 6400 NOTTINGHAM LN City BAKERSFIELD CommCode: BFD STA 09 EPA Numb: SiteID: 015-021-001338 BusPhone: Map : 123 Grid: lOA (661) 832-7814 CommHaz : Low FacUnits: 1 AOV: SIC Code:0742 DunnBrad: Emergency Contact JENNA CONNER Business Phone: 24-Hour Phone Pager Phone / Title 1 l.-.A-s.g~ SAFETY (661) 832-7814x () x () x / / ) ) ) x x x Hazmat Hazards: Contact : JENNA CONNeRo-E.~ MailAddr: 6400 NOTTINGHAM- LN ' City BAKERSFIELD Owner Address City CLIFF VAN KOPP DVM 6400 NOTTINGHAM LN BAKERSFIELD Period Preparer: Certif'd: ParcelNo: to Emergency Directives: PROG A - HAZMAT Emergency Contact Title MGR Business Phone: 24-Hour Phone Pager Phone Fire ImmHlth DelHlth Phone: (661) 832-7814x State: CA Zip 93309 Phone: (661) 832-7814x State: CA Zip 93309 TotalASTs: = Gal TotalUSTs: = Gal RSs: No ENT'D AUG 0 1 2007 Based on my inquiry of those individua.ls responsible lor obtaIning the information, ! C2!-tlty under penalty c'l law.t.hat I, have person~lly examined and am b.rmllar wIth the Informadon submitted and bslieve the intormation is true, accur -',' nd complete. . . (;,/}(f 7- IF -()7 Date -1- 07/16/2007 1'1:,:_ '. F STOCKDALE VETERINARY HOSPITAL p= Hazmat Inventory MCP+DailyMax Order SiteID: 015-021-001338 1 By Facility Unit 1 Fixed Containers on Site 1 Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP OXYGEN F IH DH G 250,00 FT3 Low -2- 07/16/2007 LOOr./9T./LO -(- . . . ... ." <::f /,.. )-- ..... ~ " F STOCKDALE VETERINARY HOSPITAL p= Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN SiteID: 015-021-001338 1 Facility Unit: Fixed Containers on Site 1 Days On Site 365 Location within this Facility Unit SURGERY ALCOVE Map: Grid: CAS # 7782-44-7 STATE - TYPE Gas Pure PRESSURE Above Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS, CYLINDER Largest Container 25,00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 250,00 FT3 Daily Average 250.00 FT3 %Wt. RS CAS# 100,00 Oxygen I Compressed No 7782447 - - HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS . . -4- 07/16/2007 ~,.;;, ..oJ --:""",,,," i; ~ F STOCKDALE VETERINARY HOSPITAL I Notif./Evacuation/Medical Agency Notification Employee Notif./Evacuation Public Notif./Evacuation SiteID: 015-021-001338 "I Fast Format 1 Overall Site 1 Emergency Medical Plan - -:_- -=-- ~~ -- ~--- -5- 07/16/2007 .l~ ~~ ~ F STOCKDALE VETERINARY HOSPITAL I Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-001338 9 Fast Format "I Overall Site "I Release Containment ..-.".....-.~ ----.",---.,.:...- ~~._-.,..,.--.,. ~ --~~-~----. ------: - - _r-..::::..:.,~- Clean Up 02/27/2007 ALL STAFF HAS BEEN TRAINED IN PROPER CLEAN-UP PROCEDURES USING THE MSDS BOOK. ._-~ -","",--",.~ -,--:"--=- ~-, Other Resource Activation -6- 07/16/2007 ,.c.....:. .J, ') , . STOCKDALE VETERINARY HOSPITAL SiteID: 015-021-001338 1 Fas t Format 1 Overall Site "I Site Emergency Factors Special Hazards Utility Shut-Offs A) GAS - BEH BLDG BET VET HOSPITAL & CHARTER HOSPITAL B') ELECTRICAL :..-- aUIoS-IDE BLDGNEXTTO --PARKINGLbT-' ---,---- -- -~ C) WATER - OUTSIDE BLDG BEH VET HOSPITAL & CHARTER HOSPITAL D) SPECIAL - NONE E) LOCK BOX - NO 01/23/2007 Fire Protec./Avail. Water 08/08/2006 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ( FIRE HYDRANT - CRNR NOTTINGHAM & SUTTON PL Building Occupancy Level 02/27/2007 20-25 PEOPLE -7- 07/16/2007 -~--- - - --------.-- ~4_-'-1' ~r l' , STOCKDALE VETERINARY HOSPITAL SiteID: 015-02l-001338 ~ Fas t Forma t ~ Overall Site ~ 02/27/2007 Training Employee Training BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE TRAINED USING THE MSDS, ICM, RADIATION MONITORING, BLOODBORNE PATHOGENS STANDARD, EMERGENCY SPILL KITS, EMERGENCY ACTION PLANS - FIRE, EARTHQUAKE, ETC, AND IIPP. Page 2 Held for Future Use Held for Future Use -8- 07/16/2007 __.-: -f':'-c.-~-- / rtol "'. _1, BAKERSFlEW FIRE DEPI' Prevention Services 900 Truxtun Ave.. Suite 210 Bakersfield. CA 93301 If) Tel.: (661) 326-3979 I J\~v Fax: (661) 872-2171 . f UNIFIED PROGRAM INSPECTtON CHECKLIST it2t-l.~,,':;->; _\'1;~"::.'8~~~~X~r..,':;;'lS~~'::',,~'"l'-~~ ,:,!.r.fiI;..,,:,.;:': ::ti-' .,;;;"-'\:(d~f~".';:~'~-"'.;,T.:ir'.~""::<;,"'-,, '..'t......"".,;.~. ,:-."';", .; -_:--::;;,/;,"., ,"';"'-;,., .- '.''-:i .I:.~':"-,' i~ .SECTION 1: Business Plan and Inventory Program U6f'P ~t~ /J\J INSPECTION TIME Section 1: Business Plan and Inventory Program COMBINED '0'- JOINT-AGENCY------cJ MUL TI-AGENCy-1r- COMPLAINT 0 C V (C=comPliance) V=Violation OPERATION COMMENTS ApPROPRIATE PERMIT ON HAND WI (..L... PRc>Jt()c. TO YVu AJ--rz:~ Julvi: 2a:1G. ~~ lJ>uJ ~\ ~D ~D ~D 12"0 ~D Business PLAN CONTACT INFORMATION ACCURATE VISIBLE ADDRESS CORRECT OCCUPANCY VERIFICATION OF INVENTORY MATERIALS ~7E- -fl7C-C<... (~6-42) 1-.JS/{)(3 X -flaY ~ c9X:~ v:: c r-:- 7< {() ,,Js,Oc ~oOGc/l.V,AUdVc o VERIFICATION OF QUANTITIES VERIFICATION OF LOCATION o PROPER SEGREGATION OF MATERIAL o @ VERIFICATION OF MSDS AVAILABILITY -2f 0 VERIFICATION OF HAl MAT TRAINING P~E OBTAIN ~ e>>lYG-C-N ~ ~-~y ~(,~ o VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~D EMERGENCY PROCEDURES ADEQUATE o CONT AINERS PROPERLY LABELED 'I tI fIJ07 AN Ex IT I S CO~-a- ~ ~6AR... W~-re: l-AlYEe- ?fwJtl)C-O AY HOUSEKEEPING FIRE PROTECTION I( II PLCASC: f42iJvloC A 2A- {O lS:c: (1\1 u,8RV tx<CV). SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ~'>-rE r=, xER.... 9lYES 0 NO (S-OAL.) I~-~~_~___.____ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 WlNe5 " In I Shift of SlteJStation # ~/t&.. {b~ siness Site/School Site Responsible Party (Please Print) Inspector (Please Print) While - Pr8Venlion Services Yellow - Station Copy Pink - Business Copy F02049 (Rev. 02105) "'{, "\ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 171SCheltttr Ave., 3rd Fl6or, Bakersfield, CA 93301 ~l:1O ~~:r"^' :tf-zco Section 4: Hazardous Waste Generator Program INSPECTION DATE 31 '2..<;' /06 EP A ID # (S-cS S<3l<0 FACILITY NAME ~~' t/Sl.. Wsf.>. o Routine jl-Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Hazardous waste detennination has been made V EP A ID Number N/A ( CCS-Q6-) Authorized for waste treatment and/or storage V . Reported release, fire, or explosion within 15 days of occurrence ~ ~ Established or maintains a contingency plan and training v Hazardous waste accumulation time frames V Containers in good condition and not leaking .,/ Containers are compatible with the hazardous waste V' Containers are kept closed when not in use V Weekly inspection of storage area V Ignitable/reactive waste located at least 50 feet from property line ,J J ~ Secondary containment provided VJ iC_c.... P~v.f)F Conducts daily inspection of tanks /oJ Ik Used oil not contaminated with other hazardous waste '" 'k Proper management of lead acid batteries including labels tI, 14- Proper management of used oil filters ~ I I\- Transports hazardous waste with completed manifest V" Sends manifest copies to DTSC V' p~c;:: ~GJP ;^-.J (...AS'! (j:)f"Y Retains manifests for 3 years V Retains hazardous waste analysis for 3 years V' Retains copies of used oil receipts for 3 years M :A- Detennines if waste is restricted from land disposal 1/ C=Comphance V=Vlolatlon Inspector: fA} I tJ'E5 Office of Environmental Services (661) 326-3979 While - Env. Svcs. Pink - Business Cop Business Site Responsible Party ~~ -~~~.c i: CHEMICAL DESCRIPTION FORM '" HAZARDOUS MATERIALS INVENTORY ~,.... ...l If a ~ m",,-..,. . UaKersnelQ Jnre JJept. Environmental Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel: (661) 326-3979 (HMMP) HAZARDOUS MATERIALS MANAGEMENT PLAN o NEW ~DD o DELETE o REVISE 200 (One form per material, per building, or area.) Paae1 of 2 i I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA. Doing Business As) 3 CHEMICAL LOCATION 201 CHEMICAL LOCATION 20 / 1\1';' Oc 5CJ~l( ALCOJr=- CONFIDENTIAL (EPCRA) DYes 0 Nc FACILITY 10 No, I I I II I I I I I I I 1 MAP No. (optional) 203 GRID NO, (optional) 20 13'31:, II. CHEMICAL INFORMATION CHEMICAL NAME 205 ' 206 o 'I- Y 6<::,--J TRADE SECRET DYes 0 No If Sub'ect to EPCRA rAfer to instructions COMMON NAME 207 EHS' DYes o No 208 CAS No, 209 'If EHS is "Yes; all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210 TYPE 211 21 CURIES 21 ~URE o m MIXTURE o w WASTE RADIOACTIVE: DYes o No LARGEST CONTAINER 21, PHYSICAL STATE o s SOLID o I LIQUID ~AS 214 Z.S- ~RESSURE RELEASE 21E FED HAZARD CATEGORIES, o 1 FIRE o 2 REACTIVE o 4ACUTE HEALTH o 5 CHRONIC HEALTH (Check all that apply) ANNUAL WASTE 2171 MAXIMUM 218 AVERAGE 219 STATE WASTE 22( AMOUNT DAILY AMOUNT 'Z s-o DAILY AMOUNT 2-~ CODE 221222 0 UNITS o ga GAL ~ CU FT o Ib LBS o tn TONS DAYS ON SITE If EHS, amount must be in Ibs, 22 STORAGE CONTAINER o k BOX o pTANKWAGON (Chack all that apply) 0 a ABOVEGROUND TANK 0 fCAN 0 b UNDERGROUND TANK 0 g CARBOY I ~ CYLINDER o q RAIL CAR 0 c TANK INSIDE BUILDING 0 h SILO o m GLASS BOTTLE o r OTHER 0 d STEEL DRUM 0 j FIBER DRUM o n PLASTIC BOTTLE 0 e PLASTIC(NONMETALLlC DRUM 0 jBAG o 0 TOTE BIN K. aa ABOVE AMBIENT 22 STORAGE PRESSURE 0 a AMBIENT o ba BELOW AMBIENT STORAGE TEMPERATURE X.a AMBIENT 225 o aa ABOVE AMBIENT 0 ba BELOW AMBIENT 0 c CRYOGENIC %WT HAZARDOUS COMPONENT EHS CAS # 1 226 227 DYes 0 No 228 22 2 230 231 DYes 0 No 232 23, 4 238 239 DYes 0 No 240 241 5 242 243 DYes 0 No 244 24, III. SIGNATURE PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 24E r&J 3,h~/06. FD2086 ,~~us MATE~~~~~~!'I~GE~~~T ~LAN _. '"__~~: r CHEMICAL DESCRIPTION FORM " HAZARDOUS MATERIALS INVENTORY UaKersnelQ 141re uept. Environmental Services 900 Truxtun Ave.. Ste. 210 Bakersfield. CA 93301 Tel: (661) 326-3979 o NEW ~DD o DELETE o REVISE 200 (One form per material, per building, or area.) Paae1 of 2 I. FACILITY INFORMATION . BUSINESS NAME (Same as FACILITY NAME or DBA. Doing Business As) CHEMICAL LOCATION 201 CHEMICAL LOCATION 20 CONFIDENTIAL (EPCRA) o Yes 0 Nc FACILITY 10 No. I I I II I I I I I I I 1 MAP No, (optional) 203 GRID NO, (optional) 20 1~'3g II. CHEMICAL INFORMATION CHEMICAL NAME 205 206 WAsTE t:: i)(. C.../C... TRADE SECRET [] Yes 0 No If Sub'ect to EPCRA refer to instructions COMMON NAME 207 EHS' DYes o No 20, CAS No. 209 'If EHS is "Yes," all amounts below must be in Ibs, FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 21C TYPE 211 21 CURIES 21 [] P PURE o m MIXTURE ~WASTE RADIOACTIVE: [] Yes o No LARGEST CONTAINER 215 PHYSICAL STATE o s SOLID ~IQUID [] g GAS 214 S- ?(:GHRONIC HEALTH 216 FED HAZARD CATEGORIES o 1 FIRE o 2 REACTIVE o 3 PRESSURE RELEASE o 4 ACUTE HEALTH (Check all that apply) ANNUAL WASTE 2171 MAXIMUM 218 AVERAGE 219 STATE WASTE 22C AMOUNT DAILY AMOUNT S- DAILY AMOUNT S- CODE q UNITS' ~a GAL, 221222 o cf CU FT o Ib LBS o tn TONS DAYS ON SITE If EHS, amount must be In Ibs. 22 STORAGE CONTAINER [] k BOX o P TANK WAGON (Chack alllhat apply) 0 a ABOVEGROUND TANK 0 fCAN 0 b UNDERGROUND TANK 0 g CARBOY [] I CYLINDER o q RAIL CAR 0 c TANK INSIDE BUILDING 0 hSILO o m GLASS BOTTLE o r OTHER 0 d STEEL DRUM 0 i FIBER DRUM o n PLASTIC BOTTLE ~ PLASTIC/NONMETALLIC DRUM 0 jBAG o 0 TOTE BIN ';It.... a AMBIENT 22 STORAGE PRESSURE 0 aa ABOVE AMBIENT 0 ba BELOW AMBIENT STORAGE TEMPERATURE ~ AMBIENT 225 o aa ABOVE AMBIENT 0 ba BELOW AMBIENT 0 c CRYOGENIC %WT HAZARDOUS COMPONENT EHS CAS # 1 226 227 o Yes 0 No 228 22, 2 230 231 o Yes DNa 232 23 4 238 239 o Yes 0 No 240 241 5 242 243 o Yes 0 No 244 245 III. SIGNATURE PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 .--tl) 3h~~b FD2086 t\ ~~ + STOCKDALE VETERINARY HOSPITAL ======================= SiteID: 015-021-001338 + Manager : ocation: 6400 NOTTINGHAM LN City BAKERSFIELD BusPhone: Map : 123 Grid: lOA (661) 832-7814 CommHaz: Low FacUnits: 1 AOV: CommCode: BFD STA 09 SIC Code:0742 EPA Numb: DunnBrad: +==============================================================================+ +=======================================+======================================+ Emergency Contact / Ti tIe t Emergency Contact / Ti tIe JENNA CO~ Ea.. /ast f'\~.<'.~ I Scbt ~(y\'<N<. / Business Phone: (661) 832-7~14X Business Phone: () x 24-Hour phone : ( ) - x 24-Hour Phone : () x Pager Phone () - x Pager phone () x +---------------------------------------+--------------------------------------+ I Hazmat Hazards: Fire React ImmHlth DelHlth I _ ~_+ - -.-:..::--- -;:::. -.::'-=_-': - -= ,-:'-=-: -,-: -.=- - - ':::::':.c- - -."," --- =.-=- -=-=--..,;;:.:: -::-,- :- -,- - _- - - -- - - -:- - -,~-."" - - -, -- -- - -,- - -,.,. - - - - - -+ -'-.: Contact : JENNA CONNOR Phone: (661) 832-7814x MailAddr: 6400 NOTTINGHAM LN State: CA City : BAKERSFIELD Zip : 93309 +------------------------------------------------------------------------------+ Owner Phone: (661) 832-7814x Address : 6400 NOTTINGHAM LN State: CA City : BAKERSFIELD Zip : 93309 +------------------------------------------------------------------------------+ WeriOd : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal ertif'd: RSs: No arcelNo: +------------~----~---------------------/~------------------------------------+ Emergency Dlrectlves: ~JV PROG A - HAZMAT h ~ \ \ PROG H - HAZ WASTE GEN V \-\~~4 \ ~ rIf) --.-.? . ENflJ AU6 6 8 2005 - --.- - - " 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, accurate, and complete. ~-<l- 04 Date ~-=============================================================================+ -1- 03/31/2006 ~ -,' r~ Stockdale V eterinary' Hospital , . 6400 Nottingham - Bakersfield, Ca 93309 i Ward ;" X-Ray R u n s '. Treatment Area Groom v Surgery EXIT Laundry Pharmacy Lab Isolation . . Food Storage Exam Room #3 Exam Room #2 Exam Room #1 Office Roof Exit --------- Dr's Office I \ EXIT Reception Restroom ~~ ~ ~~ / ~~~~ ~~C> :):... Atrium . Haz Waste . Fire Extinguisher i_ J First Aid Kit * Safety Manual 6 Water Fountain V Eye Wash Station Smoke Detector G> Spill Kit . MSDS Manual * Medication :-: Sterilizer .. Fire Alann . Emergency Kit IIlI:::J X-Ray o Sprinkler @Safety Compliance Services (818) 552-2114