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STOCKDALE VETERINARY HOSPIT~L~ cI~
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4-7070 I
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STOCKDALE VETERINARY HOSPITAL
Manager: Goy iYf\ 1Y\05.'S
Location: 6400 NOTTINGHAM LN
City BAKERSFIELD
CommCode: BFD STA 09
EPA Numb:
SiteID: 015-021-001338
BusPhone: (661) 832-7814
Map : 123 CommHaz: Low
Grid: lOA ,Facunits: 1 AOV:
SIC Code:0742
DunnBrad:
Emergency Contact
JENNA CONNER
Business Phone:
24-Hour Phone
Pager Phone
/ Title
/ ASST SAFETY
(661) 832-7814x
() x
() x
Hazmat Hazards:
Contact : JENNA CONNOR
MailAddr: 6400 NOTTINGHAM LN
City BAKERSFIELD
Owner
Address
City
ex, .~ \jar" \<opp t>\j JJ\
6400 NOTTINGHAM LN
BAKERSFIELD
Period
Preparer:
Certif'd:
ParcelNo:
to
Emergency Directives:
PROG A - HAZMAT
~ HAZ- WA.51E GEM
B3S.HJ on my inquiry of .those i,ndividua.ls
rofjpOMlb!~ for obtaining the Information, , certify
uAt;ll!lr pGflalty of law,t.hat I, have person~IIY
examiMd and am familiar with the informatIOn
submitte and believe the information is true,
accura and Co;1\ete.
~'1~[~t,vJ d -d 1- 0 'I
51 ~nature Date
Emergency Contact / Title
MGR /
Business Phone: ) x
24-Hour Phone ) x
Pager Phone ) x
Fire React 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 F' cS
" 26 2007
-1-
02/16/2007
;'! .i
F STOCKDALE VETERINARY HOSPITAL
p= Hazmat Inventory
p== MCP+DailyMax Order
SiteID: 015-021-001338 9
By Facility Unit 9
Fixed Containers on Site 9
IspecHazlEPA Hazards I Frm I DailyMax IUnitlMCP
Hazmat Common Name..,
OXYGEN
WASTE FIXER -.tJt. '1(1 J O'{}e!' lAAe ~.
F
IH DH
G
L
250.00 FT3 Low
5.00 GAL Min
R
-2-
02/16/2007
. .,
-3-
02/16/2007
F STOCKDALE VETERINARY HOSPITAL
f= 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
- TYPE
Pure
PRESSURE ---- TEMPERATURE
Above Ambient 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
HAZARDOUS OMPONENT
%'Wt. RS CAS #
100.00 Oxygen, Compressed No 7782447
C
S
HAZARD ASSESSMENTS
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Low
f= Inventory Item 0002
F= COMMON NAME / CHEMICAL NAME
WASTE FIXER
Facility Unit: Fixed Containers on Site 1
Days On Site
365
Location within this Facility Unit
Map:
Grid:
CAS #
STATE - TYPE
Liquid Waste
PRESSURE
Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
DRUM/BARREL-NONMETAL
Largest Container
5.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
5.00 GAL
Daily Average
5.00 GAL
%Wt. I
Silver
HAZARDOUS COMPONENTS
~
CAS # 74402241
HAZARD ASSESSMENTS
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies R / / / Min
-4-
02/16/2007
F STOCKDALE VETERINARY HOSPITAL
I
p= Notif./Evacuation/Medical
Agency Notification
SiteID: 015-021-001338 '9
Fast Format '9
Overall Site '9
Employee Notif./Evacuation
Public Notif./Evacuation
Emergency Medical Plan
-5-
02/16/2007
F STOCKDALE VETERINARY HOSPITAL
I
f= Mitigation/Prevent/Abatemt
Release Prevention
SiteID: 015-021-001338 9
Fast Format 9
Overall Site 9
Release Containment
Clean Up
J411 vs:l a.Ji '1 M 0Wl J;-Twned 01 '-f'<oper ciLM '-'f
. . I-h 1"1<\ /J S. 0tJo ~ ~
~oc('c~ vlW'/l~ ~le c-
Other Resource Activation
-6-
02/16/2007
..
F STOCKDALE VETERINARY HOSPITAL
I
p= Site Emergency Factors
Special Hazards
SiteID: 015-021-001338 1
Fast Format 1
Overall Site 1
Utility Shut-Offs
01/23/2007
A) GAS - BEH BLDG BET VET HOSPITAL & CHARTER HOSPITAL
B) ELECTRICAL - OUTSIDE BLDG NEXT TO PARKING LOT
C) WATER - OUTSIDE BLDG BEH VET HOSPITAL & CHARTER HOSPITAL
D) SPECIAL - NONE
E) LOCK BOX - NO
Fire Protec./Avail. Water
08/08/2006
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS
FIRE HYDRANT - CRNR NOTTINGHAM & SUTTON PL
~uilding Occupancy Leve~
JVera y d () , ,;; ~ '-'fXOfJ-1.R- ~t Cl JA 7 { '-7"" XI ~ "Z
-7-
02/16/2007
..
~ ..- .: ~
F STOCKDALE VETERINARY HOSPITAL
I
F Training
Employee Training
. SiteID: 015-021-001338 9
Fas t Format 9
Overall Site 9
l\..ll~pJD~ ~ J:,rcU'l..-UL i.l.D,;"y ~ ~SDSI
~CJi I -^.o..dJ.o.:~~ f'Y'oVton~r ) hJooJ~1~ --pc:ttho~.
~Cv1dor-<t / .e.rner~u? ~ K.--th / ~r>1er?,c.:? oc.&d1
~MS - ~l fc.ALlt~u.o-k htc. / J...IPP,
Page 2
Held for Future Use
Held for Future Use
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02/16/2007