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Home My WebLink AboutBUSINESS PLAN 11/29/2006BKFLD HEART HOSPII~AL ~ B ! 3001 SILLECT AVENUE .~ ~. + BAKERSFIELD HEART HOSPITAL __________________________ SiteID: 015-021-001987 + Manager Location: 3001 SILLECT AVE City BAKERSFIELD CommCode: KCFD STA 66 EPA Numb: BusPhone: (661) 316-6000 Map 102 CommHaz High Grid: 23D FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title RANDY ROLFE / PRESIDENT / Business Phone: (661) 316-6000x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact Phone: (661) 316-6000x MailAddr: 3001 SILLECT AVE State: CA City BAKERSFIELD Zip 93308 Owner HEART HOSPITAL OF BAKERSFIELD LLC Phone: (661) 316-6000x Address 3001 SILLECT AVE State: CA City BAKERSFIELD Zip 93308 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ENr~ PROG C - COMM HOOD /ir 1 s PROG T - ABOVEGROUNDESTORAGE TANK ~Q v z e~ Z 0®6 PROG U - UST ~a:~ed an my inquiry of those individuals rtl~panslble for obtaining the infarmation, I certify under penalty of law that I have personally ek~mirl2d and am familiar with the information sut3mitted and believe the infarmation is true, acburate, and campiete. '~ Ilz oV ~~~., ..a,~.....~ Signature Date -1- 04/04/2006 •'t l UNIFIED PROGR~-M INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 (ADDRESS PHONE Ivo. ~ No. of Employees 3~~0 •ICiv~'V Business ID Number 6 15-02 I - ~Gj 0 Section 1: Business Plan and Inventory Program ^ Routine C$Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection C ~ f C=Compliance OPERATION V=Violation COMMENTS d ~^ APPROPRIATE PERMIT ON HAND ~ 0 l~^ BUSINESS PLAN CONTACT INFORMATION ACCURATE - - - - ^ VISIBLE ADDRESS l~^ CORRECT OCCUPANCY ~ ~^ V ERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES [x~/ ^ VERIFICATION OF LOCATION l3/ ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE ~^ VERIFICATION OF I"'IAT MAT TRAINING ~~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES I.J ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED _ .___ _. --- ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8c ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES ^ NO EXPLAIN: QUESTIO REGARDING THIS INSPECTIONS PLEASE CALL US AT (6G1~ 32G-3979 ,. Inspector Badge No., White • Environmental Services Yellow • Station Copy ~--~ Business Site Responsible Party Pink -Business Copy C j~ 0~~w~~' ?c~~\\ CITY OF BAKERSFIEL.U FIRE DEPARTMENT ~~ ~ ~ ~~ OFFICE OF ENVIRONNIEN'I'AL SERVICES j`° , yp' UNIFIED PROC:RANI INSPECTION CHECKLIST \~=k'E~ A4~~~~~, 1715 Chester. Ave., 3"`' Floor, Bakersfield, CA 93301 FACILITY NAME ,~jQlCer~~lc~d ~ar~ ~SI~~~~ INSPECTION DATET~GG; Section 2: Underground Storage 't'anks Program ^ Routine ^ Combined ^ Joint Agency Type of Tank (~J~rC.S Type of Monitoring ~LO~ ^ Multi-Agency ^ Complaint ^ Re-inspection Number of "Tanks a Type of Piping QU? 1=1`cX OPERATION C t% COMMENTS Proper tank data on file Proper owner/operator data on tilt Permit fees current Certification of Financial Responsibility ~ Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations `~ Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE, CAPACITY Number oI'T'anks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/laheling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection'? C=Compliance ~ V=Violation Y=Yes N=NO Inspector: l~ Office of Environmental Services (661) 326-3979 white - 1'nv. Svcs. Pink - t3usincss Cory Business Site Responsible Party ,- UNIFIED PROGRAM INSPECTION CHECKLIST~~ ~~~~ .SECTION 1: Business Plan and Inventory Program ~ BAKERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE, INSPECTION TIME i~ ~r ADDRESS' HONE NO. OOF EMPLOYEES ~~qq C /~ j/ -~--^^ FACILITY CONTACT ~ USINESS ID NUMBER 15-021- Section 1: Business Plan and Inventory Program ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE•INSPECTION C V (°-Con"pl'~) OPERATION V=violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE a ~^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~ t(J ~, /U ^ VERIFICATION OFQUANTITIES - ~\ ^ VERIFICATION OF LOCATION ^ ~~- O PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY l Li` V L ~---^ VERIFICATION OF HAZ MAT TRAINING \ ~~^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~, ^ EMERGENCY PROCEDURES ADEQUATE I ~^ CONTAINERS PROPERLY LABELED /~ ^ (/ ~ HOUSEKEEPING /~ ^ v FIRE PROTECTION ~ ~ ~~o~ ~ 1.~ ~ ~/~~ ^ SITE DIAGRAM ADEQUATE 6 ON HAND _ _ -- ANY HAZARDOUS WASTE ON SITE? ^ YES ^ NO EXPLAIN: ~ ESTIONS REGARDING THIS INSPECTIONS PLEA8E CALL U8 AT (8tT1) 326-3979 ~ ~~lo~. Inspector (Please Print) Fire Prevention / 1n In / Shift of Site/Station q usutess SHe/School Site Responsible Party (P Print) _ White -Prevention Services Yellow -Station Copy Pink - 8uainess Copy FD20L9 (Rw. OZlO5) ,~ ~ • ,1~~4~$LL pfd v ,i4 ~ ~ CITY OF I3AKERSFIEi.D FIRE DEPARTMENT e ~ ~ b~ OFFICE OF ENViRON1~9ENTAL SERVICES ~' y~` UNIFIED PROGRAM INSPECTION CHF,CKLIST ~,;w ~~ti,,,'-, 1715 Chester Ave., 3~`' Floor, Bakersfield, CA 93301 FACILITY NAME~~~S~`F~ ~~A~7 /~D~`?oQl Section 2: Underground Storage Tanks Program INSPECTION DATE~Z~ ^ Routine ~-Combined ^ Joint Agency ^Mult1-Agency ^ Complaint ^ Re-inspection Type of Tank b ~ Number of "Tanks Type of Monitoring X161 ~~~ ~~~ Type of Piping ~ d1; OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? YeS NO Section 3: Aboveground Storage Tanks Program TANK SIZE(S) TYpe of Tank AGGREGATE CAPACITY Number of Tanks _______ ___ OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection'? C=Compliance V=Violation Y=Yes N-NO Inspector: rl~dll~ C'rf1,~7.~ I `~ Office of Environmental Services (661) 326-3979 white - Fnv. Svcs. Business Site Responsible Party Pink -Business C~~py UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program Prevention Services >3 E a_ s F , _ 0 900 Truxtun Ave., Suite 210 F/RE Bakersfield, CA 93301 ARiM t Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPE TION D TE >> zy a~ INSPECTI~I TIME i ~ ~ ~. a~ ~ ~- ADDRESS Od ( S 1 LL E GT ~ n E ~ PH~NE NO. _~ "JU, ~2j NO OF~ OYEES FACILITY CONTACT BUSINESS ID NUMBER / ~./ 15-021- l ~ S Y/ Section 1; ~B~isinessPdan and~~rt~rrenta~y~P~ogra>~_ = -~ ~`~ ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=corilpliance~ OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~3~p ~~~ ^ BUSIr1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLEADD.RESS ~®\1 ~ ~ Z006 ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~~ ^ VERIFICATION OF QUANTITIES ~/ /~ ^ VERIFICATION OF LOCATION ^ _ PROPER SEGREGATION OF MATERIAL ~ 1 ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ ~ ~® ~~ S~~ ~, ~ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ~~ FIRE PROTECTION ~ ~QR., L ` ~ ~f~.,T~,~C~') ~ ~lS\ ~$~2 N )~~,~.[1 ~j) N, / ^ SITE DIAGRAM ADEQUATE & ON HAND `n ~A'^ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # Business Site //Responsible Parry (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 nor-ou i ~ ANY HAZARDOUS WASTE ON SITE? YES ~NO ~„ S' ~~` T~`~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES °' •y UNIFIED PROGRAM INSPECTION CHECKLIST .~~ ~~~~ 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME ~ -~ t~~ t ELF 1-~E.-ARt e-la sp, ~r-* L INSPECTION DATE 2-~ ~~ ~' Section 4: Ilazardous Waste Generator Program EPA ID # ~ ~~ ~ ~ 8c1 1 ^ Routine ~ Combined ^ Joint Agency ^Multl-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number I~~ ~~-r.:st~, '~'-' Authorized for waste treatment and/or st_ orage ~~,n„d ~ ~ ~ , W ;,C ~ ~; >~ Reported release, fire, or explosion within IS days of occurrence 1v11b 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 Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste ~ ~p Proper management of lead acid batteries including labels ~ ~ ~~sLtt ~'~-a-~ Proper management of used oil filters 1J ~, 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 ~,=~,ompuance v=v-otanon -IG~,!~ 7 Inspector: Office of Environmental Services (661) 326-3979 White -Env. Svcs. Pink -Business Copy ~' _ Business Site Responsible Party !~ r ~' ..._~. ;~ INSPECTIONS B E R S F I L D BUSINESS PLAN & ~ rM r INVENTORY PROGRAM '- UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~AKCP..S~'4,t_n !{E~t ~-}cs~~-ffl~- Section 2: Underground Storage Tanks Program INSPECTION DATE: ~--~ G7` ^ Routine ~ Combined ^ Jois~t Agency ^ Multi-Agency Co plaint ^ Re-Inspection Type of Tank .~ ~~ s~1 Cl•.d• ~G._ Number of Tanks Type of Monitoring ~ ~ ky~.-r,o Type of Piping ~R~ss~a2s n ul OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations ` ~ Has there been an unauthorized release? ^ Yes,_ o Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: ~'~~~ h.~;,s ~ G~ Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Aggregate Capacity Number of Tanks -"Ty'""~-~' Business Site Responsible Party Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) s~ ~_. ~, a~ - L-~rik: HF'riF''I" Fi' i:~:F' 1 TriL Br'};ER~:}~ lELll t:ri A i ~L.L F'UP~JC'L 1 ~:+I•J ~~ ,hd~+1:'P'1rL ~-.._- +,r~:iI_Uf'lE = 4~Jt,l ~:~r=iL:~~ 90r; UL1_r;~_ 1= 9:;9 Gr'!I..=_~ Ti_ ,+.?'7LIIh'IE = 4444 C~r!L~: HEIGHT = r=~" . ~ 0 ~I:I'4!:~ HE TEI°iP = 60 . i I L:~EG F t 2 : F.4 r 11_E!' 1:, I ESEL '':?4LUi°ll~: = 5595 ~:,~L LJl_Lti!:~E = 405 GAL: '~O~r; IJLL~i;E= i ~=~tiL T~ ~ 'ti"~ ±LUf"lE = 5575 G~;L HEIi~HT = h4.90 IhJ!.:HE 1;.1hfiEN `~•it!L = U t_ rLE: I,Jr';TEk = 0.00 II'~Ji'HE'.=_~ a: ~. ~ ~ E I: JI; ~ ~ .. :x " ~ ate;, ~ fW y ,~ a ;3UU 1 ~ 1 LEE! "I' HtJF' :~''fS`I'EI"1 : ~`Cr`1'LI:_: Ri.~l-'?~F'I~ F;LL FI_ihJC' I' 1 ~:Pd: LJ±_,F'I'1F;1.. `I" I;~~~EFdEFir~`I' C:F'. C~(F:=:EL HEIR=.FI"I' _ ';`~.Ii; ,-fd~'f~lh~~ , W~TEf~: - _ ~ i . i Jib l l'J~_:I JI~,_. T - : L-JC~ , .1.1 HEIGHT - . - , ,_,,'? 1 fJC'f-Il_:`~ Wh'1'EI? IiC~J. [I i~h,".. I,.I~;TEF' _ ~ i . t:iLi l hd~: FJ}=:: TEf~9F' - E.2.. L!EG F' ice.. BAKERSFIELD HEART(„HOSPITAL Manager : ,_'~r.~rnc .S v0.Li i, ~ ~ Location: 3001 SILLECT AVE City BAKERSFIELD CommCode: KCFD STA 66 EPA Numb: ~~5~ g BusPhone: Map 102 Grid: 23D SiteID: 015-021-001987 (661) 316-6000 CommHaz High FacUnits: 1 AOV: SIC Code: DunnBrad: ~<v~ ~ e~ ~ ~~ ~ non r t~Ti Emergency Con ac / Ti e Emergency Contact / TiPtle pia t ~~7D3~ "~~-- / PRESIDENT Torre ~a~iN ~ o S Yhc~+JEtZCi}inr / ,4 t- Business Phone: (661) 316-6000x Business Phone: (t~~,~ )~52 -lo~i~l x 2 4 -Hour Phone ( ) - x 2 4 -Hour Phone ((otoi ) ~3 a - .38~ b x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact ""*T"~' "^T °° ~~"~-~~ \~e-~\P.~c, c~- Phone: (661) 316-6000x MailAddr: 3001 SILLECT AVE State: CA City BAKERSFIELD Zip 93308 Owner HEART HOSPITAL OF BAKERSFIELD LLC Phone: (661) 316-6000x Address 3001 SILLECT AVE State: CA City BAKERSFIELD Zip 93308 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD PROG H - HAZ WASTE GEN , , Qn ' O PROG T - ABOVEGROUND STORAGE TANK O ' PROG U - UST .~/` IV CIV~~U ~~p ('~ Aqq ~41~J/ C3ased on my inquiry of those indiviriu~l;~ nsible for obtaining the information, I oertify respo under penalty of law that I have per~anally examined and am familiar with the Information submitted and believe the informatlon is true, accurate, and complete. ~- ~~ ~ ~ :~~c.,~.~- x'11 `1 ~ ~' Signature Date -1- 04/18/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: • FACILITY/SITE INFORMATION Business Name: BAKERSFIELD HEART HOSPITAL Cross Street :. Business Type: Org Type: Total Tanks 2 IndnRes/Trust: No PA Contact: Dsg Own/Oper BRETT A TACKET ICC Nbr: 5243805-UC PROPERTY OWNER INFORMATION Name Phone: ( ) - x Address: City Type CORPORATION State: Zip: TANK OWNER INFORMATION Name Phone: Address: City State: Zip: Type CORPORATION x BOE UST Fee# UNKNOWN Financ'1 Resp: STATE FUND Legal Notif Business Mailing Address Date:ll/08/1999 Phone: (316) 6000 xto~}~( Name:TOMAS GALINDO Tt1:FACILITY MANAGER State UST # 1998 Upg Cert#: -2- 04/18/2007 ._ F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP NITROUS OXIDE F P IH G 12000.00 FT3 Hi PHOTO DEVELOPER AND FIXER IH L 200.00 GAL Hi DIESEL FUEL ##2 F R IH DH L 6000.00 GAL Low DIESEL FUEL #2 F R IH DH L 6000.00 GAL Low OXYGEN (LIQUID) F IH DH L 2000.00 GAL Low OXYGEN F IH DH G 1000.00 FT3 Low NITROGEN F P IH G 40000.00 FT3 Min COMPRESSED AIR G 660.00 FT3 Min PLAZ GAS P G 3000.00 FT3 UnR WASTE MEDICAL IH DH S 500.00 LBS UnR WASTE LAB F IH DH L 50.00 GAL UnR WASTE PHOTOGRAPHIC FIXER & DEVE DH L 40.00 GAL UnR WASTE RADIOLOGICAL R IH DH L 20.00 MCI UnR -3- 04/18/2007 -4- 04/18/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME NITROUS OXIDE Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 10024-97-2 ~GaSATE TYPE T PRESSURE TEMPERATURE CONTAINER TYPE TPure I Above Ambient Ambient IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 FT3 12000.00 FT3 10000.00 FT3 tit',GAtcLVU~ ~:VinrViv~iV1~ ~Wt. RS CAS# 100.00 Nitrous Oxide No 10024972 YIAGHKIJ 1'~J~1';J~1~1L'' 1V 1"J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH j / j Hi ~ Inventory Item 0011 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PHOTO DEVELOPER AND FIXER Days On Site 365 Location within this Facility Unit Map: Grid: DARKROOMS NEXT TO OATH LABS CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 GAL 200.00 GAL 5000.00 GAL i1HGEitCLVUJ 1..V1~lYV1V~1V1~ ~Wt. RS CAS# Acetic Acid, Anhydride No 108247 Aluminum Sulfate No 10043013 1'lEiGEiKL [-» .7~~7.71~1L" 1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Hi -5- 04/18/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Inventory Item 0006 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME DIESEL FUEL #2 Days On Site 365 Location within this Facility Unit Map: Grid: S OF AMBULANCE ENT CAS# 68476-34-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 6000.00 GAL 6000.00 GAL 6000.00 GAL HP,LARDOUS COMPONENTS %Wt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 nr~c~r~uu~ tiJJ1,JJ1~1~1v1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Low ~ Inventory Item 0007 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME DIESEL FUEL #2 Days On Site 365 Location within this Facility Unit Map: Grid: S OF AMBULANCE ENT CAS# 68476-34-6 Liquid TMixture T Ambient~E ~ A~PeRATURE ~EROGROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 6000.00 GAL 6000.00 GAL 6000.00 GAL HAZARD - OUS COMPONENTS %Wt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 rltiGtiRL H JJI;JJ1"1Li1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Low -6- 04/18/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME OXYGEN (LIQUID) Days On Site 365 Location within this Facility Unit Map: Grid: S OF TRUCK SERVICE ENT CAS# 7782-44-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TPure ~-Above Ambient Cryogenic IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 2000.00 GAL 2000.00 GAL 20000.00 GAL tit~~t~rcvvu~ ~viYir~ivr~ivla %Wt. RS CAS# 100.00 Oxygen, Liquid No 7782447 nr~~r~tcL r~a~~~~i~ir,lvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit STATE TYPE PRESSURE _ Gas TPure ~-Above Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 77$2-44-7 TEMPERATURE CONTAINER TYPE Ambient IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest 10000100rFT3 Daily1000100m FT3 I Dai180000r00e FT3 tiEiG.-itcLVUJ 1,V1~lYV1V~1V 1.7 %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 11HGHlCL H~ J.7~JJl~lt',1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -7- 04/18/2007 ~, F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME NITROGEN Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 7727-37-9 ~GasATE T TYPE T PRESSURE TEMPERATURE CONTAINER TYPE I Pure I Above Ambient Ambient IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest-Container Daily Maximum Daily Average 40000.00 FT3 40000.00 FT3 30000.00 FT3 ri1~GH1tLVUJ 1.V1~lYV1VL"1V1~ $Wt. RS CAS# 100.00 Nitrogen No 7727379 t1E]GEitGL HJ JJ;JJ1"1J;1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0004 COMMON NAME /.CHEMICAL NAME COMPRESSED AIR Location within this Facility Unit VARIOUS LOCATIONS Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# ~GasATE TPureE ~ Ambient~E ~ AmbPeRATURE IN MAGCHINEjEQUIPPE AMOUNTS AT THIS LOCATION Largest Co660100rFT3 - Daily 660100m FT3 ~ Daily 500r00e FT3 rltiGtit~CLVUJ 1.V1~lYV1Vl:,1V1J %Wt. RS CAS# 100.00 Air No 0 titiGHtCL HJ JI;JJ1~1r,1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No ~ No No No/ Curies / / / Min -8- 04/18/2007 F BAKERSFIELD HEART HOSPITAL ~ Inventory Item 0005 COMMON NAME / CHEMICAL NAME PLAZ GAS Location within this Facility Unit VARIOUS LOCATIONS ~GaSATE TYPE -~ PRESSURE TMixture I Ambient SiteID: 015-021-001987 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE Ambient IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 3000.00 FT3 3000.00 FT3 2000.00 FT3 HAZARDOUS COMPONENTS °sWt . RS CAS# 1'1HGHKL L~.7 .7~~J.S1~1L' 1V 1 w7 - - TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA U5DOT# MCP No No No No/ Curies P / / / UnR ~ Inventory Item 0009 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE MEDICAL Days On Site 365 Location within this Facility Unit Map: Grid: WASTE STORAGE AREA SERVICE ENT CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid Waste Ambient Ambient BIN AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 1000.00 LBS 500.00 LBS HAZARDOUS COMPONENTS °sWt RS CAS# HAZARD AS SESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / UnR Daily Average 50000.00 LBS -9- 04/18/2007 F BAKERSFIELD HEART HOSPITAL ~ Inventory Item 0013 COMMON NAME / CHEMICAL NAME WASTE LAB Location within this Facility Unit LAB HAZ WASTE STORAGE SitelD: 015-021-001987 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# Liquid TWaste ~mbient~E ~ AmbientT~E DRUM/BARRELENONMETAL~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 GAL 50.00 GAL 2500.00 GAL %Wt. RSI CAS# nt~~tittL t~a a~~~in~ly 1 a TSecret RS BioHaz RadioactivejAmount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / UnR ~ Inventory Item 0012 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE PHOTOGRAPHIC FIXER & DEVELOPER Days On Site 365 Location within this Facility Unit Map: Grid: X-RAY DEVELOPING STA AT OATH LAB CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste ~mbient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 40.00 GAL 40.00 GAL 1500.00 GAL HAZARDOUS COMPONENTS , °sWt . RSA CAS# tll'~GEittL 1~a52SJb1~1~1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / UnR HAZARDOUS COMPONENTS -10- 04/18/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Inventory Item 0010 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE RADIOLOGICAL Days On Site 365 Location within this Facility Unit Map: Grid: WASTE STORAGE AREA SERVICE ENT CAS# STATE T TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid I Waste -~mbient ~ Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Con20100rMCI Daily M20100m MCI I Daily7500r00e MCI %Wt. RSA CAS# riE~GEittL A7~~~71~1r,1VlJ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH DH / / / UnR HAZARDOUS COMPONENTS -11- 04/18/2007 F BAKERSFIELD HEART HOSPITAL SitelD: 015-021-001987 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 11/21/2000 ~ DETECTION OF HAZARDOUS MATERIALS RELEASE THROUGH INVENTORY CHECKS, DIRECT OBSERVATION FROM EMPLOYEES. DETECTION OF DIESEL RELEASE AT FUEL UST SITE THROUGH INVENTORY CHECK WITH FUEL METER, ALARM FROM ELECTRONIC LEAK DETECTOR, VISUAL OBSERVATION DURING INSPECTION, ANNUAL TANK INTEGRITY TESTING. DETECTION OF AIR EMISSIONS RELEASE EXCEEDING LIMITS THROUGH SOURCE TESTING OF EXHAUST. DETECTION OF UNAUTHORIZED WASTE WATER DISCHARGE THROUGH ANY REQUIRED SAMPLING BY CITY WASTE WATER DIVISION AND INSPECTION OF THE NEUTRALIZATION Employee Notif./Evacuation 09/29/2006 UPON DISCOVERY OF A RELEASE OR THREATENED RELEASE, EMPLOYEE SHALL NOTIFY IMMEDIATE SUPERVISOR, WHO SHALL NOTIFY DISASTER SUB-COMMITTEE CHAIR. AS SOON AS PRACTICABLE, THE CHAIR OR DESIGNEE, WILL MAKE TELEPHONE NOTIFICATIONS TO THE REGULATORY AND EMERGENCY RESPONSE AGENCIES AS LISTED IN THE FACILITY COMPLIANCE PLAN ON SITE. Public Notif./Evacuation 11/21/2000 THE EMERGENCY PREPAREDNESS MANAGEMENT PLAN PORTION OF THE FACILITY COMPLIANCE PLAN MAINTAINED ON SITE DESCRIBES HOW THE ORGANIZATIONS WILL ESTABLISH AND MAINTAIN A PROGRAM TO ASSURE EFFECTIVE RESPONSE TO ANY DISASTER OR OTHER EMERGENCY AFFECTING THE ENVIRONMENT OF CARE, THEREBY ENSURING A TIMELY, COORDINATED RESPONSE TO EMERGENCY SITUATIONS. -12- 04/18/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Emergency Medical Plan 09/29/2006 RESOURCES AVAILABLE TO THE BAKERSFIELD HEART HOSPTAL IN AN INCIDENT INCLUDE: FIRST AID KITS; MEDICAL PERSONNEL AND FACILITY; EMERGENCY SHOWER; AND LABORATORY CHEMICAL SPILL TREATMENT KIT. 9 -13- 04/18/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 11/21/2000 TO ASSES THE HAZARD POTENTIAL OF REGULATED SUBSTANCES HANDLED, THE FACILITY COMPLIANCE PLAN MAINTAINED ON SITE HAS IDENTIFIED AREAS AND MECHANICAL SYSTEMS WHERE AN INCIDENT COULD OCCUR OR WOULD REQUIRE IMMEDIATE INSPECTION OR ISOLATION BECAUSE OF VULNERABILITY TO EARTHQUAKE RELATED GROUND MOTION. 9 Release Containment RESOURCES AVAILABLE INCLUDE: 09/29/2006 LABORATORY: CHEMICAL SPILL TREATMENT KIT AND MERCURY SPILL CLEAN-UP KIT MATERIALS MANAGEMENT: HAZMAT SPILL RESPONSE KIT RADIOLOGY: NUCLEAR SPILL KIT PHARMACY: CHEMOBLOC SPILL KITS Clean Up 09/29/2006 POSSIBLE RESTORATION ACTIONS AFTER AN INCIDENT ARE AS FOLLOWS: WASTE MATERIALS PROPERLY TRANSFERED, TREATED, AND DISPOSED; EMERGENCY EQUIPMENT DECONTAMINATED; AND DISASTER SUBCOMMITTEE DOCUMENTATION AND PERSONNEL DEBRIEFED. FOLLOW-UP ACTIONS: WRITTEN REPORTS TO AGENCIES AS REQUIRED; INCIDENT DOCUMENTATION IN OPERATING RECORDS; FACILITY COMPLIANCE PLAN REVIEW FOR AMENDMENTS; AND POST-INCIDENT EVALUATION. V1..1101 iCC.5VLL1 l:C til.:L1VCLL1V11 -14- 04/18/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards Utility Shut-Offs S'°trc` m~ip O'F U'F ~ ~ e u'T~ ~Z ~ ~~~+T. ~rrS t_~ t4"tr`O «t Er~c~ ~+~t E2t~5 7c~"c ° r1LC t'IVI.C(.:. /tiVd11. Wdl.Cl. ~~tq 1~7 Building Occupancy Level -i~-~fZTJ'tT6 4~~~~~~ 350 EMPLOYEES -15- 04/18/2007 J ~ . ' F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 09/29/2006 ~ MSDS SHEETS ON FILE. BRIEF SUNIMARY OF TRAINING PROGRAM: GENERAL ORIENTATION DRILLS, ANNUAL TRAINING, ANNUAL SAFETY TEST, EDUCATION VIA COMPUTER 7. rcayC ~ Held for Future Use nclct tvL r uLU.ie use -16- 04/18/2007 BAKERSFIELD HEART HOSPITAL Manager TOMAS GALINDO Location: 3001 SILLECT AVE City BAKERSFIELD CommCode: KCFD STA 66 EPA Numb: SiteID: 015-021-001987 BusPhone: (661) 316-6000 Map 102 CommHaz High Grid: 23D FacUnits: 1 AOV: SIC Code: DunnBrad: i'z-iLr..~ez.~ 'P~i O~z.~ ~NTECz-j N~ Ps~,5~7E~T Li V Emergency Contact / Title Emergency Contact / Title / T ,D T_TIwwTTT TOMAS GALINDO / PLANT OPS MGR Business Phone: (661) 316-6000x Business Phone: (661) 852-6471x 24-Hour Phone ( ) - x 24-Hour Phone (661) 332-3806x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact : °-S~3ND~` I~Ef~LAi~iH --- ~ ~ ~t""`t R17 ~~-~ ~ ~ L- Phone : ( 6 61) 316 - 6 0 0 0 x MailAddr: 3001 SILLECT AVE State: CA City BAKERSFIELD Zip 93308 Owner HEART HOSPITAL OF BAKERSFIELD LLC Phone: (661) 316-6000x Address 3001 SILLECT AVE State: CA City BAKERSFIELD Zip 93308 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A- HAZMAT ENT°D A U G 0 3 Go~, PROG C - COMM HOOD PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK PROG U - UST ~~aed on my inquiry of those individuals re€pgr~rsible fAr obtaining the information, I certify under penalty of taw that i have personally examined and am familiar with the information submitted rind believe the information is true, accurate, and complete. Signature Date -1- 06/29/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: BAKERSFIELD HEART HOSPITAL Cross Street Business Type: Org Type: Total Tanks 2 IndnRes/Trust: No PA Contact: Dsg Own/Oper BRETT A TACKET ICC Nbr: 5243805-UC PROPERTY OWNER INFORMATION Name TOMAS GALINDO Phone: (661) 852-6471x Address: City State: Zip: Type CORPORATION TANK OWNER INFORMATION Name TOMAS GALINDO Phone: (661) 852-6471x Address: City State: Zip: Type CORPORATION BOE UST Fee# UNKNOWN Financ'1 Resp: STATE FUND Legal Notif Business Mailing Address Date:ll/08/1999 Phone: (316) 600- x Name:TOMAS GALINDO Tt1:FACILITY MANAGER State UST # 1998 Upg Cert#: -2- 06/29/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP NITROUS OXIDE F P IH G 12000.00 FT3 Hi PHOTO DEVELOPER AND FIXER IH L 200.00 GAL Hi DIESEL FUEL #2 F R IH DH L 6000.00 GAL Low DIESEL FUEL #2 F R IH DH L 6000.00 GAL Low OXYGEN (LIQUID) F IH DH L 2000.00 GAL Low OXYGEN F IH DH G 1000.00 FT3 Low NITROGEN F P IH G 40000.00 FT3 Min COMPRESSED AIR G 660.00 FT3 Min PLAZ GAS P G 3000.00 FT3 UnR WASTE MEDICAL IH DH S 500.00 LBS UnR WASTE LAB F IH DH L 50.00 GAL UnR WASTE PHOTOGRAPHIC FIXER & DEVE DH L 40.00 GAL UnR WASTE RADIOLOGICAL R IH DH L 20.00 MCI UnR -3- 06/29/2007 -4- 06/29/2007 F BAKERSFIELD HEART HOSPITAL ~ Inventory Item 0001 ~ COMMON NAME / CHEMICAL NAME I NITROUS OXIDE Location within this Facility Unit STATE TYPE Gas TPure = PRESSURE _ Above Ambient Days On Site 365 Map: Grid: CAS# 10024-97-2 TEMPERATURE CONTAINER TYPE Ambient IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 FT3 12000.00 FT3 10000.00 FT3 HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Nitrous Oxide No 10024972 t1L~GKKL Ya.7 .7L" .7a1~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0011 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PHOTO DEVELOPER AND FIXER Days On Site 365 Location within this Facility Unit Map: Grid: DARKROOMS NEXT TO OATH LABS CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 200.00 GAL 200.00 GAL II 5000.00 GAL ru~c~r-ucLVU~ ~.vl~irviv~ivla %Wt. RS CAS# Acetic Acid, Anhydride No 108247 Aluminum Sulfate No 10043013 riHI~HtCiJ 1i.7 .7~J.71~1t',1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Hi SiteID: 015-021-001987 ~ Facility Unit: Fixed Containers at Site ~ -5- 06/29/2007 F BAKERSFIELD HEART HOSPITAL ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME DIESEL FUEL #2 Location within this Facility Unit S OF AMBULANCE ENTR SitelD: 015-021-001987 ~ ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 68476-34-6 ~ STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 6000.00 GAL 6000.00 GAL 6000.00 GAL nt~~t~tcLVU~ ~viYirvlv~lvl~ °sWt . RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 ru-a~Htcli tia5~~~i~i~ly l5 TSecret RS BioHaz RadioactivejAmount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Low ~ Inventory Item 0007 COMMON NAME / CHEMICAL NAME DIESEL FUEL #2 Location within this Facility Unit S OF AMBULANCE ENTR Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 68476-34-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average _6000.00 GAL 6000.00 GAL 6000.00 GAL tstiGlitCLVU~J ~v1~1rv1v.C~1v1.7 °sWt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 tiHGHKL l-1.7J~~i51~1L"!V 1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Low -6- 06/29/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME OXYGEN (LIQUID) Days On Site 365 Location within this Facility Unit Map: Grid: S OF TRUCK SERVICE ENTR CAS# 7782-44-7 Liquid TPureE ~AboveSAmbient CryogenicRE IN MACHINE/EQUIPPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 2000.00 GAL 2000.00 GAL 20000.00 GAL •- riAG1~1C1J V U 7 l: V 1~1Y V 1V L' iV 17 owt. Rs cAS# 100.00 Oxygen, Liquid No 7782447 t11~GEitCL 1~J5~5~1~11;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 7782-44-7 ~GasATE TPureE ~-AboveSAmbient AmbientT~E IN MACHINE/EQUIPPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 FT3 1000.00 FT3 80000.00 FT3 HAZARDOUS COMPONENTS swt. RS CAS# 100.00 Oxygen, Compressed No 7782447 Llti[~tii[L HJ arJ J.71~1L,1V l~J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -7- 06/29/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME NITROGEN Days On Site 365 Location within this Facilit Unit M id G y ap: r : CAS# 7727-37-9 STATE T TYPE ~GdS i Pure PRESSURE ~~ TEMPERATURE Above Ambient I Ambient ~~ CONTAINER TYPE i IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 40000.00 FT3 40000.00 FT3 30000.00 FT3 •- HAZARDOUS COMPONENTS %Wt• RS CAS# 100.00 Nitrogen No 7727379 I1tiGtiiCL HJ JP~JJ1"1L~1V 1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME COMPRESSED AIR Days On Site 365 Location within this Facility Unit Map: Grid: VARIOUS LOCATIONS CAS# ~GasATE TPureE -~ Ambient~E ~ A~PeRATURE IN MAGCHINE/EQUIPPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 660.00 FT3 660.00 FT3 500.00 FT3 HAZARDOUS COMPONENTS , ~Wt. 100.00 Air RSI CAS# No 0 HAZARD AS SESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Min -8- 06/29/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PLAZ GAS Days On Site 365 Location within this Facility Unit Map: Grid: VARIOUS LOCATIONS CAS# ~GasATE ~Mixtur~ Ambient~E ~ AmbientT~E IN MACHINE/EQUIPPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 3000.00 FT3 3000.00 FT3 2000.00 FT3 HAZARDOUS COMPONENTS , %Wt. RSA CAS# HAZruu~ t,~ ~ a ~ ~MalV t a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies P / / / UnR ~ Inventory Item 0009 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE MEDICAL Days On Site 365 Location within this Facility Unit Map: Grid: WASTE STORAGE AREA SERVICE ENTR CAS# STATE T TYPE ~- PRESSURE TEMPERATURE -~ CONTAINER TYPE Solid I Waste I Ambient ~ AmhiPnt I RTr7 AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1000.00 LBS 500.00 LBS 50000.00 LBS HAZARDOUS COMPONENTS %Wt. RS CAS# HAZARD A SSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / UnR -9- 06/29/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ ~ Inventory Item 0013 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE LAB Days On Site 365 Location within this Facility Unit Map: Grid: LAB HAZ WASTE STORAGE CAS# Liquid. TWaste ~ AmbRent~E ~ AmbientT~E DRUM/BARRELENONMETAL~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 GAL 50.00 GAL 2500.00 GAL HAZARDOUS COMPONENTS %Wt. RSI CAS# tl[-1G1~tCL 1-1A .7r,JJ1~1r,1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / UnR ~ Inventory Item 0012 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE PHOTOGRAPHIC FIXER & DEVELOPER Days On Site 365 Location within this Facility Unit Map: Grid: X-RAY DEVELOPING STA AT OATH LAB CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste Ambient ~ Ambient DRUM/BARREL-NONMETA~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 40.00 GAL 40.00 GAL 1500.00 GAL HAZARDOUS COMPONENTS , %Wt. RS CAS# titiGtitC1J EiA.7L' ~7J1~1L"1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / UriR -10- 06/29/2007 ~ F BAKERSFIELD HEART HOSPITAL ~ Inventory Item 0010 COMMON NAME / CHEMICAL NAME WASTE RADIOLOGICAL Location within this Facility Unit WASTE STORAGE AREA SERVICE ENTR SiteID: 015-021-001987 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# Liquid I Waste ~ Ambient~E ~ AmbientT~E METALOCONTAINRTNONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 20.00 MCI 20.00 MCI 7500.00 MCI r~ HAZARDOUS COMPONENTS %Wt. RS CAS# ru~~tucL H~S~a~ri~i~ta TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH DH / / / UnR -11- 06/29/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 11/21/2000 ~ DETECTION OF HAZARDOUS MATERIALS RELEASE THROUGH INVENTORY CHECKS, DIRECT OBSERVATION FROM EMPLOYEES. DETECTION OF DIESEL RELEASE AT FUEL UST SITE THROUGH INVENTORY CHECK WITH FUEL METER, ALARM FROM ELECTRONIC LEAK DETECTOR, VISUAL OBSERVATION DURING INSPECTION, ANNUAL TANK INTEGRITY TESTING. DETECTION OF AIR EMISSIONS RELEASE EXCEEDING LIMITS THROUGH SOURCE TESTING OF EXHAUST. DETECTION OF UNAUTHORIZED WASTE WATER DISCHARGE THROUGH ANY REQUIRED SAMPLING BY CITY WASTE WATER DIVISION AND INSPECTION OF THE NEUTRALIZATION Employee Notif./Evacuation 09/29/2006 UPON DISCOVERY OF A RELEASE OR THREATENED RELEASE, EMPLOYEE SHALL NOTIFY IMMEDIATE SUPERVISOR, WHO SHALL NOTIFY DISASTER SUB-COMMITTEE CHAIR. AS SOON AS PRACTICABLE, THE CHAIR OR DESIGNEE, WILL MAKE TELEPHONE NOTIFICATIONS TO THE REGULATORY AND EMERGENCY RESPONSE AGENCIES AS LISTED IN THE FACILITY COMPLIANCE PLAN ON SITE. Public Notif./Evacuation 11/21/2000 THE EMERGENCY PREPAREDNESS MANAGEMENT PLAN PORTION OF THE FACILITY COMPLIANCE PLAN MAINTAINED ON SITE DESCRIBES HOW THE ORGANIZATIONS WILL ESTABLISH AND MAINTAIN A PROGRAM TO ASSURE EFFECTIVE RESPONSE TO ANY DISASTER OR OTHER EMERGENCY AFFECTING THE ENVIRONMENT OF CARE, THEREBY ENSURING A TIMELY, COORDINATED RESPONSE TO EMERGENCY SITUATIONS. -12- 06/29/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Emergency Medical Plan 09/29/2006 RESOURCES AVAILABLE TO THE BAKERSFIELD HEART HOSPTAL IN AN INCIDENT INCLUDE: FIRST AID KITS; MEDICAL PERSONNEL AND FACILITY; EMERGENCY SHOWER; AND LABORATORY CHEMICAL SPILL TREATMENT KIT. -13- 06/29/2007 F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 11/21/2000 ~ TO ASSES THE HAZARD POTENTIAL OF REGULATED SUBSTANCES HANDLED, THE FACILITY COMPLIANCE PLAN MAINTAINED ON SITE HAS IDENTIFIED AREAS AND MECHANICAL SYSTEMS WHERE AN INCIDENT COULD OCCUR OR WOULD REQUIRE IMMEDIATE INSPECTION OR ISOLATION BECAUSE OF VULNERABILITY TO EARTHQUAKE RELATED GROUND MOTION. Release Containment 09/29/2006 RESOURCES AVAILABLE INCLUDE: LABORATORY: CHEMICAL SPILL TREATMENT KIT AND MERCURY SPILL CLEAN-UP KIT MATERIALS MANAGEMENT: HAZMAT SPILL RESPONSE KIT RADIOLOGY: NUCLEAR SPILL KIT PHARMACY: CHEMOBLOC SPILL KITS Clean Up 09/29/2006 POSSIBLE RESTORATION ACTIONS AFTER AN INCIDENT ARE AS FOLLOWS: WASTE MATERIALS PROPERLY TRANSFERED, TREATED, AND DISPOSED; EMERGENCY EQUIPMENT DECONTAMINATED; AND DISASTER SUBCOMMITTEE DOCUMENTATION AND PERSONNEL DEBRIEFED. FOLLOW-UP ACTIONS: WRITTEN REPORTS TO AGENCIES AS REQUIRED; INCIDENT DOCUMENTATION IN OPERATING RECORDS; FACILITY COMPLIANCE PLAN REVIEW FOR AMENDMENTS; AND POST-INCIDENT EVALUATION. v~..11c1 1\G w7VU1~..G 17t. t~lva~lvll -14- 06/29/2007 P BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ w7~JC(:1d1 rldGdLU~ Utility Shut-Offs SITE MAP OF UTILITY SHUT-OFFS IN ENGINEERING DEPT OFFICE 04/23/2007 Fire Protec./Avail. Water SPRINKLER SYSTEM FIRE HYDRANT: OUTSIDE THE SITE 04/23/2007 Building Occupancy Level ~i ..,~9~~: MPLOYEES ~ ` } ~ 0 ~ 300 -15- 06/29/2007 ~, e F BAKERSFIELD HEART HOSPITAL SiteID: 015-021-001987 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 09/29/2006 ~ MSDS SHEETS ON FILE. BRIEF SLTDMRARY OF TRAINING PROGRAM: GENERAL ORIENTATION DRILLS, ANNUAL TRAINING, ANNUAL SAFETY TEST, EDUCATION VIA COMPUTER 7. rayc ~ nciu tvL L' ul.uLC U5C nclu ivi t'uLULC USA -16- 06/29/2007