The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN 4/16/2007s ~ II II BAKERSFIELD DIALYSIS CENTER - -- _ I~ 5143. OFFICE PARK DR r - - - - .. - - - .. I ~j ,, ` ~~i `~;~`~J ,~ ~ r JUL 9 2003 ,~ i~ ~ /~~ i :•~ 1, e ~~ t i ~ `~~'' '~ ¢ BAKERSFIELD DIALYSIS CENTER SiteID: 015-021-001513 Manager MIKE HILBERRY Location: 5143 OFFICE PARK DR City BAKERSFIELD BusPhone: (661) 325-4741 Map 102 CommHaz Moderate Grid: 34B FacUnits: 1 AOV: CommCode: BFD STA 11 EPA .Numb: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title STEPHEN REESE / CHIEF TECH MIKE HILBERRY / OFFICE MANAGER. Business Phone: (661) 325-4741x Business Phone: (661) 323-2847x 24-Hour Phone (661) 323-2847x 24-Hour Phone ( ) - x Pager Phone (661) 209-6314x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth ........._. Contact STEPHEN REESE Phone: (661) 325-4741x MailAddr: 5143 OFFICE PARK DR State: CA City BAKERSFIELD Zip 93309 Owner ROBERT KOPELMAN MD Phone: (661) 325-4741x Address 5143 OFFICE PARK DR State: CA City BAKERSFIELD Zip 93309• Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: ............... Emergency Directives: PROG A - HAZMAT ~ ~ ENT A ~'R ~ ~ 2Q07 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, a rate, and complete. m ~ L (~ f~~ Signatu a Date -1- 01/25/2007 r F BAKERSFIELD DIALYSIS CENTER ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-001513 ~ By Facility Unit ~ Fixed Containers at Sits ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ............. MEDICAL OXYGEN F P IH G 3400.00 FT3 Low DIESEL L 75.00 GAL Low HELIUM F P IH G 500.00 FT3 Nin -2- O1/25/~b07 -3- 01/25/2007 F BAKERSFIELD DIALYSIS CENTER SiteID: 015-021-001513 ~ ~ Inventory Item 0001 Facility .Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME MEDICAL OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: MOBILE CARTS - STORAGE RACK N END OF STORE RM CAS# 7782-44-7 STATE T TYPE T PRESSURE ~ TEMPERATURE ~ CONTAINER TYPE ". ~GaS I Pure I Above Ambient I Ambient I PORT_ PRESS. CYLINDER I AMOUNTS AT THIS LOCATION Largest'Container Daily Maximum Daily Average 25.00 FT3 3400.00 FT3 3400.00 FT3 HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 I1[-1GtitCL EiJ J~JJ1~1~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCA No No No No/ Curies F P IH / / / Lc3f+u ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE BLDG SE CRNR BEHIND FENCE CAS# Liquid TMixture ~ Ambient~E ~ AmbientT~E OTHER NTSPECIFYYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 75.00 GAL 75.00 GAL 75.00 GAS nraurucLVVJ l.Vl"lrVlVLilV1-S sWt. RS CAS# 100.00 Diesel Fuel No. 2 No 684763b2 rJti[~tuCL tiJ J.GJ JI~IP~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCA No No No No/ Curies / / / Lt~tw -4- O1/25/~007 F BAKERSFIELD DIALYSIS CENTER SiteID: 015-021-001513 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: N END OF STORE RM CAS# 7440-59-7 ~GaSATE TYPE T PRESSURE ~~ TEMPERATURE CONTAINER TYPE TPure I Above Ambient I Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 217.00 FT3 500.00 FT3 500.00 FT3 ........... HAZARDOUS COMPONENTS sWt. ~ RS CAS# 100.00 Helium No 7440597 riAGHt~CL Ha 5L551~1L1V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 0l/25/Zbo7 F BAKERSFIELD DIALYSIS CENTER S.iteID: 015-021-001513 Fast Format ~ ~ Notif./Evacuation/Medical Overall-Site ~ ~ Agency Notification 08/11/2000 ~ DIAL 911. Employee Notif./Evacuation 09/29/2005 OVER THE LOUD SPEAKERS AND PHONE SYSTEM EVACUATION ORDER GIVEN. EACH EMPLOYEE HAS SPECIFIC RESPONSIBILITIES FOR ASSISTING PATIENTS AND STAFF FRC7Ni BUILDING. Public Notif./Evacuation EACH PATIENT IS INSTRUCTED QUARTERLY ON EVACUATION PROCEDURES. 10/07/194 Emergency Medical Plan 10/07/1934 DISASTER BAGS ARE LOCATED BY EXITS - TRIAGE AREA TO BE SET UP BY CHIEF TECHNICIAN OR HEAD NURSE. -6- 01/25/2007 F BAKERSFIELD DIALYSIS CENTER SiteID: 015-021-00151.3 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 09/29/206 ~ EACH EMPLOYEE IS INSTURCTED ON PROPER HANDLING AND USE OF MOBILE OXYGEN CYLINDERS. Release Containment 09/29/20n6 CYLINDERS ARE KEPT IN MOBILE CARTS OR STORAGE RACK - LEAKING CYLINDERS HAVE REGULATORS REMOVED. IF THEY ARE STILL LEAKING, THEY ARE TO BE PLACED OUTSIDE IN LOADING DOCK AREA AND SUPPLIER NOTIFIED. l.1 C 0.11 V ~J ~~~ ~~GZ ~ ~1~~ ~ ~ ~~ ~~,~ 1 t° S a ~ j'Z - 77 ~a ~ ~~~~~~ ~ - ~$~ ~ ~3~ 22~ ~ ~~L ___ r .n i .... V l.liGt 1~.G •7V ktVG 11t. 1.1V0.1.1 V11 -7- Ol/25/~007 e^ F BAKERSFIELD DIALYSIS CENTER SiteID: 015-021-001513 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ special Hazaras Utility Shut-Offs O1/25/20d7 A) NATURAL GAS/PROPANE - N OF MAIN ENTR B) ELECTRICAL - BREAKERS ON S WALL OF BLDG C) WATER - OUTSIDE N SIDE OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - ALARM SYSTEM AND SPRINKLERS. NEAREST FIRE HYDRANT - N OF BLDG ON OFFICE PARK DR. 03/15/20n6 -8- O1/25/2~07 F BAKERSFIELD DIALYSIS CENTER, SiteID: 015-021-001513 Fast Formgt ~ Site Emergency Factors Overall Site ~ Building Occupancy Level 11/30/2005 145 EMPLOYEES 9 -9- O1/25f~007 F BAKERSFIELD DIALYSIS CENTER SiteID: 015-021-0015]:3 ~ Fast Format ~ ~ Training Overall Sits ~ ~ Employee Training 11/30/20!76 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ATTEND AN.ORIENTATION LECTURE THAT INCLUDES: READING MSDS SHEETS, LOCATION AND USE OF FIRE EXTINGUISHERS, OXYGEN CYLINDER HANDLING AND USE, DISASTER DRILL TRAINING AND RESPONSIBILITIES. WE ALSO CONDUCT QUARTERLY FIRE AND DISASTER DRILLS. rage riela for r~uLUre use nClu iui ru~uLe use -10- Ol/25/2b07 UNIFIED PROGRAM FNSPECTION CHECKLIST SECTION 1:., Business Plan and Inventory Program • ~~* Prevention Services >3 . F R s r ,_ D 900 Truxtun Ave., Suite 2.10 FIRE Bakersfield, GA 93301 aRrM Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ INSPECTION DATE INSPECTION TIME ~~z~ a,~ sus ~ ~o - ~~,d b ~ ADDRESS PHONE NO. NO OF EMPLOYEES FACILITY CONTACT `~- ~~5~ BUSINESS ID NUMBER 15-021- ~~~ Section 1: Business Plan and Inventory Program 3 ~O J ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION ' C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~N~t~ AI fl i 1 ! ~ ~,1 V l~ ^ CORRECT OCCUPANCY ( A ^ VERIFICATION OF INVENTORY MATERIALS ~ / PJ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION Is rl ^ PROPER SEGREGATION OF MATERIAL ~ / li~I ^ 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 ANY HAZARDOUS WASTE ON SITE? ^ YES NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~~1~1~ ~atil~ ~ 11 Inspector (Please Print) Fire Prevention / 1~' In /Shift of Site/Station # Business Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CFIECKLIST '' Enironmental Services .. ~ 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPECTION DATE INSPECTION TIME ~ ~ I ADDRESS PHONE No. No. ofQE,m~pl~oyees J ~~ __OF~jG~__~~2kK__~2 ---------------- 3a~J `l~~I_ -~~~.J----- --- FACILITYCONTACT p Business ID Number 5rt i` ) a~, 15 -021- 0151 Section 1: Business Plan and Inventory Program I~'Routine ^ Combined ^ Joint Agency ^hulti-Agency ^ Complaint ^ Re-inspection COMMENTS ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY I~ ^ ~ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES - ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITYE ^ ^ VERIFICATION OF HAT MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE I~ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HANG ANY HAZARDOUS WASTE ON SITE: ^ YES ^ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (661) 326-3979 .~~' Inspector (Please Print) Fire Prevention 1st-InlShift of Site White -Environmental Services Vellow -Station Copy Business Site Responsible Party (Please Pink -Business Copy ., . + BAKERSFIELD DIALYSIS ________________________________ SiteID: 015-021-001513 + Manager Location: 5143 OFFICE PARK DR City <~ BAKERSFIELD CommCode: BFD STA 11 EPA Numb: BusPhone: (661) 325-4741 Map 102 CommHaz Low Grid: 34B FacUnits: 1 AOV: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title STEVE REESE / CHIEF TECH MIKE HILBERRY / OFFICE MANAGER Business Phone: (661) 325-4741x Business Phone: (661) 323-2847x 24-Hour Phone (661) 323-2847x 24-Hour Phone ( ) - x Pager Phone ( (p(Q~,) ~Z~ -(p7j l~ x ~,e,~j Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact Phone: (661) 325-4741x MailAddr: 5143 OFFICE PARK DR State: CA City BAKERSFIELD Zip 93309 Owner ROBERT KOPELMAN MD Phone: (661) 325-4741x Address 5143 OFFICE PARK DR State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: ~ PROG A - HAZMAT ENT's ~~ ~ ~ ~ ~~~~ 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, ac~urate, and comp~le~te. Signat a Date Cl~, ~?~ eel„ /~v~oSlsf -1- 03/03/2006 Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST Enironmental services 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 TeT: (661)326-3979 FACILI AME ~ ~ O ~~~ -- - - - --- INSPECTION DATE INSPECTION TI L ADORES G `~ L ~1 1 ~~ a R- ~~~i ~r ~ ~? } PHONE No. -- No. of Employe S 6 - ------------- ------- --~ - - -- _ - - -- - FACILITYCONTACT -----~- ( ~ ___ __________ -- --- Business ID Number 15-021- aolS r ~ Section 1: Business Plan and Inventory Program ^ Routine Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection C I ~ V ^ \V=Vioaplonn~~ OPERATION APPROPRIATE PERMIT ON HAND COMMENTS , / LN ® ^ ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE VISIBLE ADDRESS CORRECT OCCUPANCY ~~,~~~ QG i~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES C~ ^ VERIFICATION OF LOCATION Lf! ^ PROPER SEGREGATION OF MATERIAL - ^ VERIFICATION OF MSDS AVAILABILITYE ---- - J lJ ^ - ----- ----- ------ VERIFICATION OF HAT MAT TRAINING --------------~------ ---------------- J L~! ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ------------- --- - ~/ LfA ^ CONTAINERS PROPERLY LABELED - --------------------- --------------.-- ------° ^ ---- - HOUSEKEEPING ---- -------- --- --------- - - J C~ IJ ^ ^ - - FIRE PROTECTION SITE DIAGRAM ADEQUATE 8c ON HAND - ------ ------- ~~~ ~~~ ~y~ e 1~ ANY HAZARDOUS WASTE ON SITE: ^ YES (~ NO /~' ' / EXPLAIN: n QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL U/S AT (66~) 3Z6-3979 ~~~v~v_-_~ _~~dN%f~-__-_~31~~q insp~or Badge No. White • Environmental Services Yellow -Station Copy ~~ ., <<~~