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Home My WebLink AboutBUSINESS PLAN 6/6/20079 ~~ JUST FOR KIDS DENTISTRY Manager ELIZA CRUZ Location: 4000 STOCKDALE HWY H City BAKERSFIELD CommCode: BFD STA 03 EPA Numb: BusPhone: (661) 327-7668 Map 102 CommHaz Minimal Grid: 35C FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact J Title Emergency Contact / Title DR MARK THOMAS / OWNER ELIZA CRUZ / MANAGER Business Phone: (661) 327-7668x Business Phone: (661) 327-7668x 24-Hour _ Phone (661) 201-8454x 24-Hour Phone (661) 903-1849x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact DR MARK THOMAS Phone: (661) 327-7668x MailAddr: 4000 STOCKDALE HWY H State: CA City BAKERSFIELD Zip 93309 Owner DR MARK THOMAS I ~~~'' ~ ~~ `~~ ~ ~~ Phone : ( 6 61 } 3 2 7 - 7 6 6 8x ~ae.,d Address 4000 STOCKDALE HWY H State: CA City BAKERSFIELD ~ Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~l .-- _ -- -- . _ __ Based on my inquicy_ of those-individuals responsible for obtaining the lnformatlon, I oortlfy --- - - - - - - - - - --- -- -- --- under penalty of law that I havo porsonally examined and am familiar with the Infarrrr&tlon submitted and believe the information IS true , accurate, and complete, Sig a r Date a~~3 SiteID: 015-021-002970 -1- 06/04/2007 ~ ~~, F JUST. FOR KIDS DENTISTRY SiteID: 015-021-002970 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... ISpecHazIEPA Hazards) Frm I DailyMax IUnitIMCPI WASTE FIXER R L ~5 :'60 GAL Min l E -2- 06/04/2007 -3- 06/04/2007 y 1 F JUST FOR KIDS~DENTISTRY ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit INSIDE NE CRNR OF RECEPTION AREA STATE TYPE PRESSURE Liquid TWaste -~ Ambient SiteID: 015-021-002970 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Contain r Daily Maximum I Daily Average j . 0 0 GAL j~ GAL ~ ~~0 GAL tiH~Htcl~vua ~:ui~irulvrlv'1'~ gWt. RS CAS# Silver No 7440224 riHGHKL H~~r;5~1~1L'~1V'15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 06/04/2007 ~ ~ F JUST FOR KIDS DENTISTRY SiteID: 015-021-002970 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification Employee Notif./Evacuation 01/30/2006 CALL 911 AND OFFICE OF EMERGENCY SERVICES 1-800-852-7550 AND BFD _. t UiJl ll.. 1VV 1..11 ~ L+V 0.tr LL0.l.l Vll Emergency Medical Plan REFER TO PHYSICIAN NEXT DOOR TO OUR OFFICE, DR. DEOL 01/30/2006 -5- 06/04/2007 ,_ '• F JUST FOR KIDS DENTISTRY SiteID: 015-021-002970 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 01/30/2006 ~ MANUAL HOLDING FIXER IS SET INTO A PLASTIC CONTAINER CAPABLE OF HOLDING ANY LEAKING MATERIAL. Release Containment 01/30/2006 ONLY ONE CONTAINER IS USED TO HOLD THE FIXER. Clean Up 01/30/2006 CONTACT BFD AND THE COMPANY - STERI-CYCLE WHO DELIVERS THE MATERIAL. v~.11ci ttc.7vuLC:C HC:L1Vdl.1(Jil -6- 06/04/2007 ~, ,. , .~ F JUST FOR KIDS DENTISTRY SiteID: 015-021-002970 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards Utility Shut-Offs 12/13/2006 NATURAL GAS/PROPANE: N SIDE OF BLDG ELECTRICAL: OUTSIDE FRONT DOOR WATER: OUTSIDE LOCK BOX: NO Fire Protec./Avail. Water 12/13/2006 FIRE EXTINGUISHERS AND ALARM SYSTEM FIRE HYDRANT OUTSIDE ON N MCDONA.LD WY Building Occupancy Level 25 EMPLOYEES 12/20/2006 -7- 06/04/2007 ~.,; - ;. F JUST FOR KIDS DENTISTRY SiteID: 015-021-002970 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 12/13/2006 ~ BRIEF SUMMARY OF TRAINING PROGRAM: CONTACT DR THOMAS TO ADVISE OF HAZARD AND CONTACT BFD/911 IF NECESSARY. rage ~ ncl,u 1_vt ru~.uic vac - 1 J L . 11G1U 1Vl 1'Ul..u1G Ve7C -8- 06/04/2007 • UNIFIED PROGRAM INSPECTION CHECKLISTIf ~..v _ __.._..~.___..._.._.___ _r _ _ ~ _ SECTION 1: Business Plan and Inventory Program B__ _E R 5 F I _.D F/RE ARTM T Prevention Services 900 Truxtun Ave:, Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME. Ji,~ -r FotZ 1~-ta5 (~~TtS(' `C INSPECTION DATE 1213-p6 INSPECTION TIME SM~~ ADDRESS , t/ 1 1 PHONE NO. ''') Q NO OF EMPLOYEES FACILITY CONTACT ~~-~ Irn/{-~1~. T~'~-OJV~ BUSINESS ID NUMBER 15-021- (7C~2~7~ Section 1: Busiiness Plan and_tnven#ary Program. ~ , ~~OUTINE ^ 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 EN~, ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS O ^ VERIFICATION OF QUANTITIES ,~/ LY ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY C3~ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES Q~ ^ EMERGENCY PROCEDURES ADEQUATE 0~^ CONTAINERS PROPERLY LABELED UST FOR KIDS ~ Dr. Mark Thomas Q~ ^ HOUSEKEEPING I~ ^ FIRE PROTECTION B' ^ SITE DIAGRAM ADEQUATE & ON HAND I DENTISTRY "Personalized, Comfortable Dental Care" ANY HAZARDOUS WASTE ON SITE? L+S YES ^ NO I X / o XPLAIN~ Yt~- 4000 Stockdale Hwy. • Bakersfield, CA 93309 (661) 327-7668 QUESTIONS REGARDI G THIS NSPECTION? PLEASE CALL US AT (661) 326-3979 3A- Inspector (Please Print) Fire Prevention / ts` In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 aF ~ ~ i ~'\ UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program ~~ FACILITY NAME ~vS~ t~'tXL ~ d~S t'»~'tS~~l ADDRESS FACILITYCONTACT Dumber ~ ~ 1- -- 15-0' ~J Section 1: Business Plan and Inventory Program ~2g7a ^ Routine ~ombined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-in C V (C=Compliance OPERATION COMMENTS ~ ~~~ `' `V=Violation ~~~ ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ --- ^ _...- VERIFICATION OF INVENTORY MATERIALS ------------- ---- ----- -- -- - } ` - nAQ w~~ - - ~'_~~L..... ^ ^ VERIFICATION OF QUANTITIES I s ~„L ^ ^ .VERIFICATION OF LOCATION lnIS,4~ ~~ L-r~~.(i ~ r~~ ~~~ ~L~ ^ ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITYE ~ l~ ^ ^ VERIFICATION OF HAT MAT TRAINING ! i A n ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES t D I... - . _. __..._..._.... _ _~~.._ ._ _____ ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ~ ~~~ PReA/t.oC~D a J {~~ ^ ^ HOUSEKEEPING ^ ^. FIRE PROTECTION ^ ^ SITE DIAGRAM ADEOUATE & ON HANG ANY HAZARDOU~S~W/A~ST~E OlN SITE: YES ^ NO EXPLAIN: W r-~'I l:. ~t ~`2-' QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~F)F)') ~ 326-3979 -~ ~.~ P 3 Inspector (Please Print) Fire Prevention 1st-In/Shift of Site Bakersfield Fire Dept. ' Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (66.1)__326-39_7 INSPECTION D TE INSPECTION TI ~l ~~~~- ~_______ mod' ___ Business ponsible P lease Prinl) White -Environmental Services Yellow -Station Copy Pink -Business Copy ?005 ,,~ .. .. ~- t~ ;~ G. CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME JAS i ~- fC~~S ~G~-~~S't`~ INSPECTION DATE '~ r(4/a,~' Section 4: Hazardous Waste Generator Program EPA ID # ~~~ ^ Routine ~-Combined ^ Joint Agency ^Multf-Agency D Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property- line Secondary containment provided PC~~~ ~U~nC Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal ~=~ompnance v=vtotanon Inspector: ~l ^~'~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. Lfw~A Busines Respo sibl Party Pink -Business Copy