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HomeMy WebLinkAboutBUSINESS PLAN 5/10/2007(~~ ~~; I {~ ic~~ ~o~ ;~ 1 ~1 3d~~Fl~~ '7~iJ~ it . it T ~: `c. II ~ Il ^~~~~~o~ ;, ~, T _.~ MERCY HOSPITAL OPERATIONS WHSE Manager JEANETT SMART Location: 551 SHANLEY ST City BAKERSFIELD CommCode: BFD STA 15 EPA Numb: Emergency Contact KEN STONECIPHER Business Phone: 24-Hour Phone Pager Phone Emergency Contact KEN LABRECQUE Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: / Title / ADM DIRECTOR (661) 632-5642x (661) 632-5000x ( ) - x Fire SiteID: 015-021-000411 BusPhone: (661) 632-5304 Map 123 CommHaz Extreme Grid: 06B FacUnits: 1 AOV: SIC Code-:4226 DunnBrad: / Title / FACILITY DIR (661) 632-5642x (661) 632-5000x (661) 337-1914x ImmHlth DelHlth Contact KEN LABRECQUE Phone: (661) 632-5642x MailAddr: PO BOX 119 State: CA City BAKERSFIELD Zip 93302 Owner CATHOLIC HEALTHCARE WEST Phone: (415) 438-5500x Address 185 BERRY ST 300 State: CA City SAN FRANCISCO Zip 94107 Period to Preparers Certif'd: ParcelNo: Emergency Directives: PROG A - HAZMAT Based on my inquiry t~f tf~~:3~ indi~kiJuals responsible for obtaining tfi© infclrmatian, I certify under penalty of law that 1 have personaNy examined and am ft~mllinr with the informatian submitted and believe the information is true, accurate, and complete. ignature Date Gall Gal ENT'D MAY 1 7 2007 ~y37 TotalASTs: _ TotalUSTs: _ RSs: No ~k~s,~ 13 -1- 05/03/2007 F MERCY HOSPITAL OPERATIONS WHSE SiteID: 015-021-000411 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP FORMALDEHYDE E F L 3600.00 ML Hi METHYL ALCOHOL F IH DH L 110.00 GAL Hi CLOROX LIQUID BLEACH F IH DH L 20.00 GAL Hi CIDEX OPA IH DH L 26.00 GAL Mod TONER F IH DH L 10.00 GAL Mod GERMICIDALS IH DH L 10.00 GAL Low -2- 05/03/2007 -3- 05/03/2007 F MERCY HOSPITAL OPERATIONS WHSE SiteID: 015-021-000411 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME FORMALDEHYDE Days On Site 365 Location within this Facility Unit Map: Grid: STOCKED FOR PATHOLOGY CAS# 50-00-0 Liquid TMixture ~mbient~E ~ AmbientT~E ~ PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 ML 3600.00 ML 1800.00 ML HAZARDOUS COMPONENTS %Wt. RS CAS# 37.00 Formaldehyde (EPA) Yes 50000 Methanol No 67561 riHGKKL H~7J~JJ1~1~1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Hi ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME METHYL ALCOHOL Days On Site 365 Location within this Facility Unit Map: Grid: WHSE CAS# Liquid TMixtur~Ambient~E ~ AmbientT~E ~STICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 110.00 GAL 20.00 GAL raa~4az[~LVVO l..Vl'1rV1VP~IJTS %Wt• RS CAS# 2.00 2-Propanol No 67630 91.00 Methyl Alcohol No 67561 r1Y~/~riRl/ 1'ii J .7.GJ J1"1P~1V l A TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Hi -4- 05/03/2007 F MERCY HOSPITAL OPERATIONS WHSE SiteID: 015-021-000411 ~ ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CLOROX LIQUID BLEACH Days On Site 365 Location within this Facility Unit. Map: Grid: , WHSE CAS# 7681-52-8 Liquid TMixtur~ Ambient~E ~ AmbientT~E ~ PLASTICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 20.00 GAL 20.00 GAL t11~GE~IKLVUJ l:Vl~ll'V1V1'~1V15 %Wt. RS CAS# 100.00 Sodium Hypochlorite No 7681529 riHGHl[L E~b.7L' Jb1~11;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Hi ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME CIDEX OPA Location within this Facility Unit WHSE STATE TYPE PRESSURE Liquid Mixture I Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 111-30-80 TEMPERATURE ~~ CONTAINER TYPE Ambient I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Cont~i0n0erG~ Daily M26im0u0m GAL ~ Daily A20r00e GAL ruiGS-uu~vva ~.vl~irvlvl~,ly 1 ~ %Wt. RS CAS# 3.00 Glutaraldehyde No 110308 r1HGL-litL H. 7.7~J.71°1~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Mod -5- 05/03/2007 F MERCY HOSPITAL OPERATIONS WHSE 5iteID: 015-021-000411 ~ ~ Inventory Item 0011 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME TONER Days On Site 365 Location within this Facility Unit Map: Grid: WHSE CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE ~Liquid~Mixtur=mbient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 10.00 GAL 4.00 GAL HAZARDOUS COMPONENTS °sWt. RS CAS# 85.00 Styrene No 100425 til-~GEiKL 1~.75~J51~1~1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME GERMICIDALS Location within this Facility Unit WHSE STATE TYPE PRESSURE Liquid TMixture Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 25655-41-8 TEMPERATURE CONTAINER TYPE Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 10.00 GAL 10.00 GAL - nr~c~titcvvu~ ~:vlYlrvivl;ivt~ °sWt. RS CAS# 10.00 Iodine No 7553562 1.00 Glycerine No 56815 riEiGEitCL H7J~.7.71~1~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Low -6- 05/03/2007 F MERCY HOSPITAL OPERATIONS WHSE SiteID: 015-021-000411 ~ Fast Format. ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/20/2000 ~ BAKERSFIELD FIRE DEPARTMENT - 911 MERCY HOSPITAL SECURITY/SAFETY DEPARTMENT - 632-5000 FACILITIES MANAGER - 632-5000 ADMINISTRATIVE COORDINATOR - 632-5000 Employee Notif./Evacuation 12/20/2000 FIRE ALARM SYSTEM, NOTIFY EVERYONE IN BLDG AND EVACUATE TO NW OF BLDG. Public Notif./Evacuation 02/09/1996 QUANTITY NOT SUFFICIENT TO REQUIRE SURROUNDING PUBLIC TO EVACUATE BECAUSE OF DISATER TO NEAREST BUILDINGS. IF REQUIRED PROBABLY A DECISSION TO BE MADE BY HAZ MAT TEAM. Emergency Medical Plan 07/21/2006 EXPOSED EMPLOYEES WOULD BE TRANSPORTATED TO MERCY SOUTHWEST EMERGENCY ROOM, TRIAGED AND TRANSPORTED TO OTHER FACILITIES AS NECESSARY. DECONTAMINATION SHOWER AVAILABLE ADJACENT TO EMERGENCY DEPT AMBULANCE ENTRANCE. -7- 05/03/2007 F MERCY HOSPITAL OPERATIONS WHSE SiteID: 015-021-000411 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 12/20/2000 ~ HAZARDOUS MATERIAL STORED AT LOWER LEVELS AND ALL MATERIALS STORED IN BOXES WITHIN ORIGINAL CONTAINERS. Release Containment 12/20/2000 SPILL KITS TO CONTAIN SMALL SPILLS. Clean Up 12/20/2000 DEPENDING ON MATERIAL AND SIZE OF SPILL, OBTAIN/REVIEW MSDS SHEETS, RECOVER IF DONE SAFELY, OUTSIDE AGENCY SUCH AS CALPI INC TO CLEAN IF NEEDED. Other Resource Activation -s- os/o3/200~ s F MERCY HOSPITAL OPERATIONS WHSE SiteID: 015-021-000411 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ JEJeC:1d1 ndzaras Utility Shut-Offs 07/21/2006 A) GAS - W SIDE OF WHSE N OF OFFICE AREA B) ELECTRICAL - ELECT RM IN HALLWAY FROM WHSE OFFICE C) WATER - W SIDE OF WHSE N OF OFFICE AREA D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 02/05/2007 PRIVATE FIRE PROTECTION - SPRINKLERES, FIRE EXTINGUISHERS, AND SPRINKLER FDC ON N SIDE OF BLDG DRIVEWAY. FIRE HYDRANT - N SIDE. Building Occupancy Level 24 EMPLOYEES 12/27/2006 -9- 05/03/2007 ;~ F MERCY HOSPITAL OPERATIONS WHSE SiteID: 015-021-000411 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 07/21/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: HAZARDOUS COMMUNICATION AND SAFETY FOR ALL NEW EMPLOYEES (GENERAL ORIENTATION}, ANNUAL EDUCATION CLASS (2 HOURS} FOR ALL EMPLOYEES. DEPARTMENT ORIENTATION AND INSERVICE TRAINING. ALL DEPARTMENTS/EMPLOYEES REQUIRED TO PARTICIPATE IN FIRE DRILLS AND DISASTER DRILLS ON AN ANNUAL BASIS. rays ~ Held for Future Use nc.LU Lvi ru~uic vac -10- 05/03/2007 Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST ~_ E R S r l ,, 9ooTruxtun Ave., suite 210 Pi-BB Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program "RrM r Tel.: (661) 326-3979 - . ~ Fax:' (6CC1) 872-2171 FACILITY NAME INSP/E-C7TION DATED TIME INS/PEry,CT/yIO_/N ' ~~ ADDRESS ~S ~ ~~~~ HON NOi~ /~~ / / 3 O OF E LOYEES v O (/ FACILITY CONTACT ~/' , ~ SS ID NUMBER B US INE 15-021- ~~ / ~jrf/jil~S ~~ W . ,~ l~ i .Section 1: ,Business Plan and Inventory Program.. - -- - - _ _ - - ~ "-e ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION ~- C V (c=compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~'J nn - ~ ( ~V V~ ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE n/P~~ ~ ~ / _ ~ 7~ ~,yC.i ~ '"`."ter ^ .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 / Gs ~G~ C~ /~/ ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QU ONS REGA N THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 r- `5 - (~ Inspector (P ase Print) ire Prevention / 1" In /Shift of Site/Station # Busine ite /,Responsible arty lease Print White -Prevention Services.. - Yellow -Station Copy ~ ~ Pink -Business Copy ~ ~ FD 2155 (Rev. 09/05 ^ YES /I~ NO + MERCY HOSPITAL OPERATIONS WHSE ______________________ SiteID: 015-021-000411 + Manager ,~~ ~~y BusPhone : ~ ~ ~~' ~-~~ ~'' Location: 551 SHANLEY ST Map 123 CommHaz High City BAKERSFIELD. Grid: 06C FacUnits: 1 AOV: CommCode: BFD STA l~ SIC Code:4226 EPA Numb: / DunnBrad: Emergency Contac~~ / Title.~~., j~ ~mergency Contact / Title ~j~, ~ vrmmv ,-,.-r*t,,,,,,-. ~' ~~~,-~r~r~r r-.~r,n~ ~$~r~11~%01-3>~ffACILITIES ~6~ Business Phone:. (661) 632-~~~ ~d~a- Business Phone: (661) ~-5 24-Hour Phone (661) 632-5000x 24-Hour-Phone (661) 632-5000 Pager Phone (~~ ~~~ ~ -Pager-Phone (661) ~-- Hazmat Hazards: Fire React ImmHlth DelHlth +-.Contact /~~" ~~~u~ -----------------------Phone: 1 (~,~) ~~ -t~ ----+ MailAddr: PO BOX 119 State: CA City BAKERSFIELD Zip 93302 + Owner CATHOLIC HEALTHCARE WEST ,~. Phone:- + Address /~ ~;~tt/~~ate: CA City SAN FRANCISCO. 3~ Zip "- Q ~ f Q'~ Period to Preparers Certif'd: ParcelNo: ` TotalASTs: _ TotalUSTs: _ RSs: No Gal Gal Emergency Directives: 1~~ PROG A - HAZMAT PROG H - HAZ WASTE GEN ENT~p ~~~ 2 ~ ~Op~ k;asud ;~n my inquiry of those individuals responsible for obtaining the information, I certify under uenaiiy of law ?hat 1 nave personally examiners end am familiar ~~vith the information submitted and belie e 'snformation is true, accurate, and compl te, /~ , 5', ~lG ~aoq ~~ ~5 -1- 03/14/2006 J .~„ r~, ~~ ~ ~ ~ Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST Enironmental Services ,~ _ - ~ 1715 Chester Ave SECTION 1 Business Pian and inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPC-_rCT~Qt~A~ INS ION TIME r ------- ------------~' -5'------------ - - ~'~ -- ----- -~°--_---- --- --------- -- -f ----- ~ ~ ADDRESS PHONE No. o. of Employees _____~__ ~_____ ~ /_j_~~_ _~ ----- -- -- ~ _~-- --~-`~ ---- -- FACIUTYCONTACT r Business ID Number -- -- - - ~ ~C~ ~ d 15-021- ~ . ._y _. Section 1: Business Plan and Inventory Program ^ Routine ^ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V \V=VoapoinnCel OPERATION COiIIIAAENTS ^ APPROPRIATE PERMfT ON HAND BUSINESS PLAN CONTACT INFORMATION ACCURATE - ---- ~J ~~p~ ~~ ~ r~ f v ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES VERIFICATION OF LOCATION _ ^ -- -- PROPER SEGREGATION OF MATERIAL ----------------------------- --------- --- ----------- - B~~'D-~~---Y 5 -2~~6------___ ____---- -__--------- ^ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF FIAT 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 INSPECTIONS P/L~EASE CALL US AT (661 ~ 326-3979 ----'C~e~-~`~-~~----( ------------------ 1 Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow -Station Copy S sine ponsibl Party (PI se rint) g N Pink -Business Copy ~