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Home My WebLink AboutBUSINESS PLAN~.: ~Y~E ~~~µ ~ ~, ~ STINE VETERINARY HOSP. f ~ ~' ~,'~,,y~ 4450 STINE ROAD, SITITE A ,~~_ \.. fig d ~~ G ~.5~~ ~~~. l y ~ %, S STINE VETERINARY HOSPITAL SiteID: 015-021-002148 Manager SARAH FRANK-SPEARS BusPhone: (661) 398-7121 Location: 4450 STINE RD A Map 123 CommHaz Low City BAKERSFIELD Grid: 15D FacUnits: 1 AOV: CommCode: BFD STA 13 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title SARAH FRANK-SPEARS / OFFICE MANAGER ROGER PAULSON / OWNER Business Phone: (661) 398-7121x Business Phone: (661) 398-7121x 24-Hour Phone (661) 397-3371x 24-Hour Phone ( ) - x Pager Phone (661) 619-6963x Pager Phone (661) 332-3835x Hazmat Hazards: Fire Reac t ImmHlth DelHlth Contact SARAH FRANK-SPEARS Phone: (661) 398-7121x MailAddr: 4450 STINE RD A State: CA City BAKERSFIELD Zip 93313 Owner ROGER L PAULSON DVM Phone: (661) 398-7121x Address 4450 STINE RD A State: CA City BAKERSFIELD Zip 93313 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ~ (';' r~'! i!'(7.~~~~1 of j~`rl^~ ,~~e kl.:~, r ~. r 1r ~;~~aininc she lntc~rrr,=..or ; ~^r'~:•~~ ~sn~7er €~?^alty c?f ia~.r, that I hcvc per^on^~i;- examir;ec; anc; am tGmiRar ~nrith the inlormet:cn s:~l~mitted and believe the information iS tru?, t e. accurate, and comple ~~ ((`` ~~// ii 5 ~1 ~ ` I°~"~` v~ 1f~~~~~~\a~1~~ ~ ~ Da4e Sognature -1- 10/05/2007 r~ F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN WASTE FIXER F IH DH G R L 502.00 5.00 FT3 GAL Low Min -2- 10/05/2007 _3_ 10/05/2007 :~ 1 F STINE VETERINARY HOSPITAL ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit OPERATING RM STATE TYPE PRESSURE _ Gas TPure Above Ambient SiteID: 015-021-002148 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 251.00 FT3 502.00 FT3 251.00 FT3 - tiHGAtCLVUb 1~V1~lYV1VI;1V1b %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 t1AGHKL H~~~~~1~1!~;1V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE PROCESS/RESTROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste -Ambient ~ Ambient ~LASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 5.00 GAL 5.00 GAL 5.00 GAL ru~c~~,tcLV V ~ ~.vl~lrvlvl;ly 1 ~ °sWt. RS CAS# Silver No 7440224 riL-~GL-1tCL 1~A.71;5.71~1~1V 1 ~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No Noj Curies R / / / Min -4- 10/05/2007 F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 06/02/2006 ~ VISUAL MONITORING OF OXYGEN TANKS. VISUAL AND BI-WEEKLY INSPECTION OF X-RAY PROCESSING CHEMICALS BY A COMPANY. Employee Notif./Evacuation 06/02/2006 AT THE FIRST SIGN OF A LEAK, NOTIFY MANAGEMENT. DEPENDING ON THE LEAK, THE APPROPRIATE AGENCY WOULD BE CALLED: FOR OXYGEN, WE HAVE A SCAVENGER SYSTEM; FOR X-RAY CHEMICAL, EITHER FIRE DEPT OR OUR WASTE DISPOSAL COMPANY, WHOSE NAME AND NUMBER IS LISTED AT THE HOSPITAL. Public Notif./Evacuation 06/02/2006 WE HAVE A CHEMICAL DISPOSAL COMPANY, PLUS WE NEVER DISPOSE OF CHEMICALS IN THE SINK OR ON THE GROUND. WE ALSO HAVE AN OXYGEN TANK MONITORING COMPANY. Emergency Medical Plan 02/12/2001 911, CONSULT MSDS AND (IIPP) INJURY ILLNESS PREVENTION PLAN. -5- 10/05/2007 F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/02/2006 ~ BI-WEEKLY - MONTHLY INSPECTIONS OF CHEMICALS. OSHA MEETING AND HANDLING LIMITS SCAVENGER SYSTEM. Release Containment 06/02/2006 WE HAVE A CONTAINMENT UNIT ON OUR X-RAY CHEMICALS. CLEAN-UP WOULD BE REFERED TO BFI/STERICYCLE CALIFORNIA IMAGING SOLUTIONS FOR CLEANING. ONLY MANAGEMENT IS TO ATTEMPT ANY ON-SITE CLEANING, IE, ROGER PAULSON, OWNER, OR SARAH FRANK, OFFICE MANAGER. Clean Up 06/02/2006 DEPENDING ON LIMIT, WE HAVE A FLOW-OVER PAIL FOR OUR CHEMICALS AND WOULD CALL OUR DISPOSAL COMPANY FOR REGULATIONS ON DISPOSAL AND CLEAN-UP. v~.iiCi 1CC~VULI:C HUl.1VcLl.1UII -6- 10/05/2007 1~ rt F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~1C1:1d1 ndz~diu~ Utility Shut-Offs ELECTRICAL - MAIN ELECT UNIT AT BEG OF OFFICES WATER - S END OF COMPLEX CTR OF BLDG 04/23/2007 Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - FRONT OF HOSPITAL. 01/22/2007 Building Occupancy Level 03/14/2006 8 EMPLOYEES -7- 10/05/2007 -c> . c ~~ F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 06/02/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: HAZARD COMMUNICATION REGULATION, HAZARDOUS OPERATIONS, LOCATION OF HCP AND MSDS COLLECTION, MONITORING TECHNIQUES AND INFORMATION OF SPECIFIC HAZARDS. rayc ~ nclu 1V1 rul.ulC U.7C I1ClU 1CJL t UI.ULC U~S'~ -8- 10/05/2007 ~~ STINE VETERINARY HOSPITAL SiteID: 015-021-002148 Manager SARAH FRANK Location: 4450 STINE RD A City BAKERSFIELD BusPhone: (661) 398-7121 Map 123 CommHaz Low Grid: 15D FacUnits: 1 AOV: CommCode: BFD STA 13 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title SARAH FRANK-SSG-~~ / OFFICE MANAGER ROGER PAULSON / OWNER Business Phone: (661) 398-7121x Business Phone: (661) 398-7121x 24-Hour Phone (661) 397-3371x 24-Hour Phone ( ) - x Pager Phone (661) 619-6963x Pager Phone (661) 332-3835x Hazmat Hazards: ~ Fire React ImmHlth DelHlth Contact SARAH FRANK "~~~~ Phone : ( 6 61) 3 9 8 - 7121x MailAddr: 4450 STINE RD A State: CA City BAKERSFIELD Zip 93313 Owner ROGER L PAULSON DVM Phone: (661) 398-7121x Address 4450 STINE RD A State: CA City BAKERSFIELD Zip 93313 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: l ` PROG A - HAZMAT ~ ~ PROG H - HAZ WASTE GEN ENT's ASR ~ ~ ~~~7 based on my inquiry of those individuals responsible for obtaining the informati on, I certify under penalty of lavr that I have personally examined and am familiar with the information submitted and belie ve the information is true, acs rate, and complete. Signatu '--~' '-- ~ V r t-` Date -1- 02/16/2007 f; ~~ F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN F IH DH G 502.00 FT3 Low WASTE FIXER R L 5.00 GAL Min -2- 02/16/200 -3- 02/16/2007 F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ ~ 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: OPERATING RM CAS# 7782-44-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER - - ~- AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 251.00 FT3 502.00 FT3 I 251.00 FT3 n1~Gt1KL V U ~ ~vl~rrvlV rlv t a ~Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 nr-~~,~-ucL r~~a~~ai~i~lv1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE PROCESS/RESTROOM CAS# Liquid TWaste ~ Ambient~E ~ AmbientT~E I PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 5.00 GAL 5.00 GAL 5.00 GAL nraurucLVVa L.vrirvi~r~l~t.7 - %Wt- RS CAS# Silver No 7440224 lltiL~L'i.RL 1'iJ JP~Aw71.1L'1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/16/2007 F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 06/02/2006 ~ VISUAL MONITORING OF OXYGEN TANKS. VISUAL AND BI-WEEKLY INSPECTION OF X-RAY PROCESSING CHEMICALS BY A COMPANY. Employee Notif./Evacuation 06/02/2006 AT THE FIRST SIGN OF A LEAK, NOTIFY MANAGEMENT. DEPENDING ON THE LEAK, THE APPROPRIATE AGENCY WOULD BE CALLED: FOR OXYGEN, WE HAVE A SCAVENGER SYSTEM; FOR X-RAY CHEMICAL, EITHER FIRE. DEPT OR OUR WASTE DISPOSAL COMPANY, WHOSE NAME AND NUMBER IS LISTED AT THE HOSPITAL. Public Notif./Evacuation 06/02/2006 WE HAVE A CHEMICAL DISPOSAL COMPANY, PLUS WE NEVER DISPOSE OF CHEMICALS IN THE SINK OR ON THE GROUND. WE ALSO HAVE AN OXYGEN TANK MONITORING COMPANY. Emergency Medical Plan 02/12/2001 911, CONSULT MSDS AND (IIPP) INJURY ILLNESS PREVENTION PLAN. -5- 02/16/2007 F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/02/2006 ~ BI-WEEKLY - MONTHLY INSPECTIONS OF CHEMICALS. OSHA MEETING AND HANDLING LIMITS SCAVENGER SYSTEM. Release Containment 06/02/2006 WE HAVE A CONTAINMENT UNIT ON OUR X-RAY CHEMICALS. CLEAN-UP WOULD BE REFERED TO BFI/STERICYCLE CALIFORNIA IMAGING SOLUTIONS FOR CLEANING. ONLY MANAGEMENT IS TO ATTEMPT ANY ON-SITE CLEANING, IE, ROGER PAULSON, OWNER, OR SARAH FRANK, OFFICE MANAGER. Clean Up 06/02/2006 DEPENDING ON LIMIT, WE HAVE A FLOW-OVER PAIL FOR OUR CHEMICALS AND WOULD CALL OUR DISPOSAL COMPANY FOR REGULATIONS ON DISPOSAL AND CLEAN-UP. V1,11C1 1CC5Vl.LLC.:C EiUl.lVdt.lCJil -6- 02/16/2007 ~i '} F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - MAIN ELECT UNIT AT BEG OF OFFICES C) WATER - S END OF COMPLEX CTR OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO 01/22/2007 Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - FRONT OF HOSPITAL. 01/22/2007 Building Occupancy Level 8 EMPLOYEES 03/14/2006 -7- 02/16/2007 . ;.. F STINE VETERINARY HOSPITAL SiteID: 015-021-002148 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 06/02/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: HAZARD COMMUNICATION REGULATION, HAZARDOUS OPERATIONS, LOCATION OF HCP AND MSDS COLLECTION, MONITORING TECHNIQUES AND INFORMATION OF SPECIFIC HAZARDS. rctyC L Held for Future Use nc.iu ivi. ru~.ui.c ~~c -8- 02/16/2007 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Bus ,......~-...:::., . .; w:.,,........,s. , :_:..;. mess Plan and Inventory Program BASERSFIELD FIRE DEPT Prevention Services a f~t~ 900 Truxtun Ave., Suite 210 ~w~r Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE NSPECTION TIME /- os c. X33 ~ /3 ADDRESS ~ HONE NO. O OF YEES ~ a ~ 98- ~~~ 1 FACILITY CONTACT USINESS ID NUMBER 15-021- p ~ 1 ~' p e 1 ~ ~ Section 1: Business Plan and Inventory Program ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ~ ^ COMPLAINT ^ RE-INSPECTION r 1 ~_J C V (c=compliance) OPERATION COMMENTS V=Violation LK ^ APPROPRIATE PERMIT ON HAND ~. ^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS _/ [~' ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES r~ V l~ ~ ~ 006 ^ 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 ^ FIRE PROTECTION f ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE,? YES EXPLAIN: ~UESTIONS REGARDING THIS INSPECTION? PLEASE CALL U8 AT (881) 328-3979 ~ ~~ / 3 ~ Inspector (Please Print) Fire Prevention / 1 w In / Shift of Site/Station q 8 ine Site/School Site Responsible P y (Please Print) d)) ~~~6 White -Prevention Services Yellow -Station Copy Pink - Buaineas Copy FD2049 (Rev. 02!05) + STINE VETERINARY HOSPITAL ____________ _______________ SiteID: 015-021-002148 + Manager ROGER L PAULSON/SARAH HERNANDEZ BusPhone: (661) 398-7121 I~ '='Location: 4450 STINE RD A Map 123 CommHaz Low ~ ,City BAKERSFIELD Grid: 14C FacUnits: 1 AOV: , CommCode: BFD STA 13 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title SARAH FRANK / OFFICE MANAGER ROGER PAULSON / OWNER Business Phone: (661) 398-7121x Business Phone: (661) 398-7121x 24-Hour Phone (661) 397-3371x 24-Hour Phone ( ) - x Pager Phone (661) 619-6963x Pager Phone (661) 332-3835x Hazmat Hazards: Fire React ImmHlth DelHlth Contact : SARAH FRANK Phone: (661) 398-7121x MailAddr: 4450 STINE RD A State: CA City BAKERSFIELD Zip 93313 Owner ROGER L PAULSON DVM Phone: (661) 398-7121x Address 4450 STINE RD A State: CA City BAKERSFIELD Zip 93313 Period to TotalASTs: - Gal Preparers TotalUSTs: = Gal Certif'cl: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~~` PROG H - HAZ WASTE GEN 1~ ,~ ENT ~ ~ ',J ~ 14 2006 -Based on my inquiry of those- individuals responsible for obtaining the information, I certify under penalty of law that I have personally exami and am miliar with the information sub d and b i e the information is true, acc r te, and co p te. ignat a Date 1 ~~~~ . 1~5~~\ -1- 06/02/2006 '` '~~' CITY OF BAKERSF[EI.D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES s ~ ~~ UNIFIED PROGRAA'l INSPECTION CHECKLIST :w y :R~,~~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 _...._ ~ j FACILITY NAME TII~E• ~7"i~Rl 1~1tdsP ADDRESS y c~-1/4 .('r~ ~F ~P~1. ~ FACILITY CONTACT .IRR~N r/tA1al< INSPECTION TIME iZl~ ~it,N- INSPECTION DATE l~'~~~~5' _ PHONE NO. t~ 9 8 - ~/eZ ~ BUSINESS ID NO. 15-210- DO 2 J y 13 NUMBER OF EMPLOYEES- Z~ Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection • OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate J Visible address J Correct occupancy J Verification of inventory materials J 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 Fire Protection J Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: Explain: ^ Yes ^ No Questions regarding this inspection'! Please call us at (661) 326-3979 White -Env. Svcs. Yellow -Station Copy Pink -Business Copy ~~.~ R61 N _,..~/,~1~ 1JIC Bustness Stte Responsible Party Inspector: Va/~ '::.i Per it to Operftte Hazardous Materials/Hazardous Waste Unified Permit '¡ CONDITIONS OF PERMIT ON REVERSE SIDE \ This permit is issued for the following: ~ Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment PERMIT ID # 015-021-002148 STINE VETERINARY LOCATION Issued by: 4450 Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave., 3Ì"d Floor Approved by: Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: 93313 FES 1 ~ 2001 Issue Date June 30, 2003 --',Æ- -e s.' to-*' 6),(~~ Sn;tDIAG~._, F'ACILlTYDIAG~r I BUsuteSSName:~~'~~~t \~~~~~J~Y\\G Business Address: ' D·' ('. ',_. f' \ 'A, 3.31?J o ::. ç \.( e..,e;",-\-\~'5~ 'f. ~ -ç::\ ~ ~ ~ ò-x- Q.,~-t- WJ =- 5cttUQV1~ on J~ .:: X(~ &t~wJ$~p1Dk~ j. =- '2:>Ç>'(\ '(\\l\lv,::> Cl\J.---\ü \'x\Q\-\û CO ::: O~~ ~ -\Ð,\'\ '(:...<s X -; \Y\®-~{\~ ~-V . ^ --- --_-!' - --.----- . . l \'~ I~ ,x-" '< e L y.. )C I.. {. Q<~d'\~r\tS . y: 1> W'fjdSfJð"'1 I- eY-- ~ 1 y. y. ~'lln ~ : }t1 ~ ~ i. f 'fJ 'fJ L u ~ ý tV\;--$¿, S{)CVCJU ~if hcls OCLuPd, . , ] \WW s~u+oW \¿",(; ¡(. )( '>I 'i ..¡., 'Texnx-\t60Je0J ')((1 \ \ X \ . \ \ 1 ± N , - >, I ";,_. ---' . ~()~\ STIN~ -'VE;~';~'N~R;'~~~P.L DEC 12 2003 ~ SiteID0;2:od2148 Manager : ROGER L PAULSON/SARAH HERNANDEZ Location: 4450 STINE RD A City BAKERSFIELD CommCode: BAKERSFIELD STATION 13 EPA Numb: /)Ee 12 <DO} BusPhone: Map : 123 Grid: 14C (661) 398-7121 CommHaz : Minimal FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact / Title SARAH HERN}\~IDgZ 'kb.V\y:.¡ OFFICE Business Phone: (661) 24-Hour Phone : (661) 397- 371x Phone (1.9~$ I.P\'\ \oQlD3 x Emergency Contact ROGER PAULSON Business Phone: 24-Hour Phone : Pager Phone / Title / OWNER/VET (661) 398-7121x () x (661) 332-3835x -- Period Preparer: Certif'd: ParcelNo: to Fire React ImmHlth DelHlth Phone: (661) 398-7121x State: CA Zip 93313 Phone: (661) 398-7121x State: CA Zip 93313 TotalASTs: = Gal TotalUSTs: Gal RSs: No Hazmat Hazards: Contact : SARAH MailAddr: 4450 STINE RD A City BAKERSFIELD Owner Address City ROGER L PAULSON DVM ,/ 4450 STINE RD A BAKERSFIELD Emergency Directives: l,;y/~ ~ a~~ ,It!:> I, Sara h Fro. Y1 k' Do hereby certify that I have (Type or print name) reviewed the attached hazardous materials manage- ment plan for \' ê3:;" ý and that it along with (Name of Business) any corrections constitute é3J complete and correct man- agement plan for my facility. ~HÞ/ 18-~~ i)~ 'fl,J ',' ,..',,oft,·, /:2 ·1..(J~ D:,,~ç WE: E~ 3J7!& -1- 12/01/2003 ~' l~ ;, '-,C F STINE VETERINARY HOSP4ItL I, f= Mitigation/Prevent/Abatemt Release Prevention L SiteID: 015-021-002148 ì Fast Format ì Overall Site ì 02/12/2001 Release Containment / / BIWEEKLY - MONTHLY INSPECTIONS OF CHEMICALS. OSHA ME LIMITS SCAVENGER SYSTEM. AND HANDLING 02/12/2001 WE HAVE A CONTAINMENT UNIT ON OUR XRAY CHEMICA S. CLEANUP WOULD BE REFERED TO BFI/STERICYCL~FOR CLEANING. ONLY MANAGEME IS TO ATTEMPT ANY ON SITE CLEANING, IE. ROGER PAULSON, OWNER OR SARAH OFFICE MANAGER. * -~ Clean Up 02/12/2001 DEPENDING ON LIMIT WE HAVE A FLOW OVER PAIL FOROUR CHEMICALS AND WOULD CALL OUR DISPOSAL COMPANY FOR REGULATIONS ON DISPOSAL AND CLEANUP. Other Resource Activation -6- 12/01/2003 T j _ STINE VETI!~I~ARY HOSPITAL / // Manag7r :i<.C0Vfl-PQuJ8)n }é(lreth ~ð)1~dc-z- Locat~on: 441.50 STINE RD A ' j City BAKERSFIELD CommCode: BAKERSFIELD STATION 13 EPA Numb: -~"., SiteID: 015-021-002148 BusPhone: Map : 123 Grid: 14C (661) 398-7121 CommHaz : Minimal FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact /. Title~CJ- Emergency Contact / Title SARAH HERNANDEZ / FAC CONTACTN\a\~ J( ~d ~\tpn. / O\.0~eK Business Phone: (661) 398-7121x ~ Bu ness Phone: (\QQ.\) 3CfB - 1/2.\ x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : Q.Ql.Q\ )333- -3~x Hazmat Hazards: Fire React ImmHlth DelHlth '~Contáct - :~Y\ \'1exncx<\d-c.z..- -- 'd~~______'~.c --phõñe~ (661f' j98-ií2i~-~ MailAddr: 4450 'STINE RD A State: CA City : BAKERSFIELD Zip : 93313 Owner STINE VETE~INARY HOSPITAL ,%d Pfu.Ù~Yì Phone: (661) 398-7121x Address : 4450 STINE RD A . State: CA City : BAKERSFIELD Zip : 93313 . Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: One Unified List 9 All Materials at Site 9 SpecHaz EPA Hazards DailyMax MCP R L 5.00 GAL Min F IH DH G 502.00 FT3 Low f= Hazmat Inventory p== As Designated Order Hazmat Common Name... WASTE FIXER OXYGEN \, 7l''lÀei LLPfìll\QJV) Do hereby certify that , have - ,j (fype or print nume) reviewed the attached hazardous materials manage- ment plan for~f\(; ~~\U\^~^ I \lV^'~hd that it along with (NameOfB~ any corrections constitute a complete and correct man- agement plan for my facility. (- /1,0/ Date 12/04/2000 <c . e e F STINE VETERINARY HOSPITAL p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME WASTE FIXER SiteID: 015-021-002148 ì Facility Unit: Fixed Containers at Site ì Days On Site 365 ,I I 1 Location within this Facility Unit INSIDE PROCESS/RESTROOM Map: Grid: CAS # STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 5.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 5.00 GAL Daily Average 5.00 GAL HAZARDOUS COMPONENTS -~~, ._CAS# 74402241-- -- ·I--..!,::.:. . ·I-Siclver . _ ____._~.~ _ __ .____ _ _ o~"'" ____:::=--___. TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min HAZARD ASSESSMENTS p= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME OXYGEN Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit INSIDE OPERATING ROOM Map: Grid: CAS # 7782-44-7 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 251.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 502.00 FT3 Daily Average 251.00 FT3 %Wt. RS CAS # 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS -2- 12/04/2000 i\ f I ~ -;,,)':'. ~ ~ e e CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATEIDALS MANAGEMENT PLAN INSTRUCTIONS: 1. 2. 3. 4. 5. To avoid further action, return this form within 30 days of receipt. TYPE/PRINT ANSWERS IN ENGLISH. Answer the questions below for the business as a whole. Be as 'brief and concise as possible., , " ' You may also attach Business Owner 1 Operäior Form and Chemical Description Form(s) to the front of this plan instead of completing SECTION 1. below for initial submission. " SECTION I: BUSINESS IDENTIFICATION DATA BUSINESS NAME:~\\ (\r\J-e.., \ei \ (ìor~\-\cDp\tQ\ LOCATION:9L\~l)~ (\t, (¿ DY\t ¥:\\rf K fu\À-~ 0\ WY\ \~ \ fì . MAILING ADDRESS: L\~c¿:jJ G\\~ (6 t=i li-\f / ~ CITY: ibo. 'KQ){s\ì e lQ STATECiL ZIP~PHONEi.QLQ\ ~01\2J PRIMARY ACTIVITY: \\\$\[\01 QQre ~JG~ OWNER: KCf(J>f L QcuÙ:,:OO rYJM . MAILING ADDRESS: L\L\fb S-\\X'\e.l Yd, Slt.ÀW PHONE:ld~\ ~Cfò 112\ \LfutiAs8¿d, ~ C\3313 EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 1.~ 0 Qw\SY\ ftrX1Qf ~e.tvì('Q( ìCln ?£\ ~l\Jì 2. SC¥oYì ~mÚoN1fz. dÇ;C2J00X"KX8t' V ~mR 24 HR. PHONE ?A~ó~ ~/-65îj / ! ! / 1 C. -- -- .. D. ~..__u 'J i'>~ e e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.I: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: \J'.'SUCÀ\ mO\\\--$"'11 ò\ CH~\'î -\-QD~5 V\~0\oJ Qnct bì wee.:(\~ \y\S~G-\-\Dn ù\. ~ýo.~ \hlX:.Q,S-::'\~ c..,\[ltJ.-\'ì'I\U:L\S, D\.\ ad~..ùM~()'\1ll· B. ,,' EMPLOYEE AND AGENCY NOTIFICATION: ~\- ~ ~{0\- S\~n ò\ ,0. W\$.. -\ò no\\~ ~~e\Î111ftA. d..Q-9-~XìcU~ 0'(\ ~ U OL\( ~ 0.QQnJQY\cM-e... ~V1òj WDv-\6 \asL wlUc\ ~'ý OXu..~(\ ~ ho..\.r€..Q., ~QQoc~if ~\\'S~ ~( 1-- (Q\.t ~mÀcø1 Vw ý \œQQ \\{t ~- if C)UV- \JJoo-\tD-\S~ ŒomÇb.fl\.{ \D\0~ (\().'f\t\R- ~ (1u.VV\~ \ "2> \i ~ö. a1-,~ ~,¡~0.9. , ," ENVIRONMENTAL RESPONSE MANAGEMENT: J ç> YìOYUL \ Yì fJ,.'5~\I,f\, C\; LO~ ~V\ìS uro,' ,(.tkvvi(\,~-\ù OX\Ò Cbvl\6 VlclScl- CL S\YDJC\'Vl\- (}~ \\' \~, I') OOlt Vlélù \ß0VVlote.S~ \'\DA- 1b Ò)\\-\8JyùMk ~ eY\vìro ~ ,,\~ oJJ~ ~ $\~ve- ~ ~\LoJl. ck:o~ Còmp. ~ 100\10D( ú\\~~ o.Ç ~tcJD \X\~"S\\\L 0'( Of\~C{1~ l0e. Q\JdÐ ~ OJ\ øxy~ -\-R(ll Y\flDY\i -\oY\ Ýlð Lò IV) P - , .. , -- -- ~- ," --.-~ J~~ L\JÝV) .., ' .. , ' EMERGENCY MEDICAL PLAN: , ( 'p'\ J\\~ '~V\-~l5Y) p~Yì ~ \ \ _ ~í0'(\S\.A.--'+ ~V\S~~ (1'r\d 11 () ) 'P ) 2 ~. .~, ::.~~.~ __ e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.2: RELEASE RESPONSE PLAN A. H~ARD ASSESSMENT AND PREYENTIO~ ~AS~^S~I\. ~ \\}JeQX\,,\ - \YloffilA~ \ '\Y5\~J\1.qn5 ~~ ~U:UJð- Œ6~ fv\.QW~ D-nt\ \bilcD-.iY~ \A V\J\.\ ~ ~~«¥A 'S~eX"h B. RELEASE CONT AIN¥ENT AND/OR MITIGATION: '7 . l,ù Q; V\O-V{; ~ e.Ð~'-f\~VJ: U-{\\ \::-ÜY' 0-0ç t ÝÚ,'-t (Jt\~~c.d?r-, ~lOvV\. lA-p- Lùtuld ~ (eJè(~,~c\' 1b ,~~ ¡~CB~'~ dJrl\'llY'C( e:t\ \~ \Yl(),(ìQO¡\.;mtvtl ì Õ-m (Ü1tm~ <1i~ oY1 "'2ì1-e.." C»U11)V!~ Ie ~~~~~~Q~. , CLE~N-UP AND RECOVERY PROCEDURESó ~V\ðJ ~ oYl u~ \: \& \r\G,vQ Ov ~\ OJ) óVex' ?O--U.Qèx (j~ ~mA ûcJ?-. CW\d Wo\i\6 ecill ~ý ð1s~æV œMQo RoY (e.gu1a1-t'0Yv8 ðY\- d1~rccm ~ ÖJ-O-(\ LL~ . , C. UTILITY SHUT -OFFS (LOCATION OF SHUT -OFFS AT YOUR FACILITY) NATURALGAS/PR~PANE: ~~ ~:~~~~~MW~)~__ __. . \ .0 .~~~~ù~ d¡jC-o/ð- SPECIAL: (ì D '(\JL LOCK BOX: YES/NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/W A TER AVAILABILITY A. B. PRIV4T~ FIRE P,ij.OT~TIQ~: w¿ \'\Qvt, 3 .Q-\(6 ui:1 f]//s1wvJ \o~ \ \f\ '-W\i,\\OJP 1+aJ ' (\ rc\ U~lJd \ 4 VV\oýW . WATER AVAILABILITY ~FIRE, HYDRANT): '-t efo t (~~o. fC1RÅ íV¿'\\X-\\ì~~~ cß: \\1;pIW 3 e _ HAZARDOUS MATERIALS MANAGEMENT PLAN -o..p--.. ~"": SECTION III: TRAINING NUMBER OF EMPLOYEES: <6 a.\1a~9è MATERIAL SAFETY ,DATA SHEETS ON FILE: \l e..,~ - BRIEF SUMMARY OF TRAINING PROGRAM: , I \ " ,~ QM-O\Cko.J fCA0/0 ~<1 L_Ofd C.-Offi\Y\LW\ (ULtl'bn ~ lÅJ\()..,~ OVð- \-\ðvqýif1d CJJ0 0 PefcJ1ÒY\!d-- '\b~lJYì c>; \-\G9 ~ mS0~ LQ)\\Q,cl~Dy) ffioY\\ WY\05 kdtt1iqrLU/Y'. .. ' JVlWv'tV\~m on ~Ç;'Cl4-%tYld.o_ I, ð ~ ~,J~ CERTIFY THAT THE ABOVE INFORMATION IS AC UID\.TE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERÌALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMA ION CONSTITUTES PERJURY. ~_'(O~ TITLE DATE 4 e e OSHA Meeting Date: Meeting started: In attendance: Given by: Topics: Each employee was shown how to locate the MSDS Sheets and how to read them. Gave the employees examples on a spill, they were then to look up the chemical and shown how to read the sheets. Employees were shown how to lift heavy animals/food/boxes. Use legs to lift not your back. If they need help they are to ask for help. When moping the floor or there's an urine mess, put the WET FLOOR sign up until the mess it dry, Watch for electrical cord; don't string them from one end of the hospital to the other, potential for tripping. When doing repetitive motion, i.e. computers, take a break every few minutes. Stretch fingers, move neck around, get up and stretch and rest your eyes. Watch for fractious animals. We have the rabies pole, laundry baskets and other means to get to an animal without getting bit. All cats need to be in carriers and mean dogs are to stay outside until ready to be seen or if needed Dr. can go out and tend to the dog outside. Document charts when we have fractious animals. Eye wash station was shown to the employees and how to work it. Fire extinguishers located and shown how to operate. Scavenger system & X-ray chemical procedures. Fire, earthquake, any natural disaster shown and told on how to handle them. Meeting place for front area, next to the mailbox. Report any and all accidents, spills as soon as possible so the proper measures can be addressed. e '7'7'1llp rr/I ~ ::t~-\L\~ \3~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~rt,.fiE V t21- (-l&>~p " ADDRESS 44,Ç"b ~ .,NE ~ ~ A FACILITY CONTACT SÀMI{ ~fir,/f)~ INSPECTION TIME INSPECTION DATE PHONE NO. BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES tt /"7 I '2.A:Jð , I "x-vJ g' Section 1: Business Plan and Inventory Program o Routine ~mbined o Joint Ag~ncy o Multi-Agency o Complaint ORe-inspection , OPERATION C V COMMENTS Appropriate penn it on hand ~ ?Ql~ 11'"' '~L-I r! Business plan contact infonnation accurate Visible address I;~ ! ¡- Correct occupancy .h¡¡s an appointment with 1~- L * *- .' Verification of inventory materials I~ STINE VETERINARY HOSPITAL L 4450 Stine Rd" Suite A - Bakersfield, CA 93313 Verification of quantities Telephone: (661) 398·7121 L I*~é) www,stinevet.net Verification of location o MON, o TUES. 0 WED, 0 THURS. 0 FRJ, 0 SAT. L Proper segregation of material I ~ A,M, I ~. ,AT P.M, We reserve the right to charge for appointments canceUed ~ Verification of MSDS availability or broken without 24 hours advance notice, ' c'-- Verification ofHaz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled 1./ PU:~6 /....AßéL p(.2.o-P~ Housekeeping ~ Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation \ Any hazardous waste on site?: Explain: WA.<; r<= rO(GlL.- ,¡gy es 0 No White - Env. Svcs. Yellow - Station Copy Pink - Business Copy ~f\&~(VIf\(~Vlq~ usiness Site Responsi e Party Inspector: W tNC-S Questions regarding this inspection? Please call us at (661) 326-3979 e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME <?Tl-J'G v€"\'... ..Jð~p,rl)..(.... INSPECTION DATE ¿A /1 /7-O<X) Section 4: Hazardous Waste Generator Program EP A ID # ,J!k o Routine Ø- Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Hazardous waste detennination has been made EP A ID Number (Phone: 916-324-1781 to obtain EP A ID #) 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 V YLC-.A!3€ PRòVIOG lfT/2AV" 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 Detennines if waste is restricted from land disposal C=Compliance V=Violation ~\¥i~ \lw\'l("'&- Business Site Resp sible Party Inspector: Office of Environmental Services (661) 326-3979 White - Env. Svcs. tAl ( vVC-$ Pink - Business Copy .. CITY OF BAKERSFIELQA OFFI{;E OF ENVIRONMENTAL S.VICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION CHEMICAL LOCATION 200 (one form per material per buitding or arrJa) Page of ~W , ' , . o Yes 0 No 202 204 , CHEMICAL NAME WM-rG- ç:::; ~ C-'L.. 207 COMMON NAME CAS # 209 FIRE CODE HAZARD ClASSES (Complete if requested by local fire chief) 210 TYPE o P PURE o m MIXTURE PHYSICAL STATE o s SOLID &.aUlD FED HAZARD CATEGORIES o 1 FIRE o 2 REACTIVE (Check all thaI apply) ANNUAL WASTE ~ 217 MAXIMUM AMOUNT DAILY AMOUNT 1\STE 211 RADIOACTIVE DYes oNo 212 CURIES 213 o ,9 GAS 214 LARGEST CONTAINER s- 215 o 3 PRESSURE RELEASE o 4 ACUTE HEALTH o 5 CHRONIC HEALTH 216 ,~ 218 AVERAGE DAILY AMOUNT 219 STATE WASTE CODE 220 UNITS· ~GAL odCUFT . If EH5, amount must be in Ibs. o Ib LB5 o In TONS 221 DAYS ON SITE 222 I I I i I I STORAGE CONTAINER (Check all that apply) o a ABOVEGROUND TANK o b UNDERGROUND TANK DC TANK INSIDE BUILDING o d STEEL DRUM ~snCINONMETALLlC DRUM OrGAN 09 CARBOY o h SILO o i FIBER DRUM OJ BAG Ok BOX o I CYLINDER o m GLASS BOTTLE o n PLASTIC BOTTLE o 0 TOTE 81N o p TANK WAGON o q RAIL CAR o r OTHER 223 STORAGE PRESSURE ~ AMBIENT o aa ABOVE AMBIENT o ba BELOW AMBIENT 224 STORAGE TEMPERATURE t%-a AMBIENT o aa ABOVE AMBIENT o ba BELOW AMBIENT o c CRYOGENIC 225 o Yes 0 No 228 230 231 DYes 0 No 232 233 i 3 234 235 oYesoNo 236 237 I I I 4 238 239 o Yes 0 No 240 241 i 5 242 243 o Yes 0 No 244 245 UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd .. CITY OF BAKERSFIEL~ OF~E OF ENVIRONMENTAL S.VICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per material per budding or a1&8) Page of '1\~~{;,t ~~;~' ;;i.¡,::·'2iJY;'··¡.5,~i~; " :'NFØRMA1:JON~":. BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ç (r"oV'~ V c::?r...- ~P..-- . fJ ~ (~G... e:R~'<,..J§... CHEMICAL LOCATION CHEMICAL NAME ð x.YG--C,.J o Yes 0 No 208 COMMON NAME CAS # 201j CHEMICAL LOCATION I CONFIDENTIAL (EPCRA) GRID # (optional) 207 209 FIRE CODE HAZARD ClASSES (Comp1ete if requested by local fire DYes 0 No Dyes DNa 202 204 o Yes 0 No 206 If Subject to EPCRA. refer to instrudions 210 TYPE ~URE 213 o m MIXTURE o w WASTE 211 RADIOACTIVE 212 r CURIES i PHYSICAL STATE o s SOLID 215 o I LIQUID ~5 LARGEST CONTAINER '2~l FED HAZARD CATEGORIES (Check all that apply) ANNUAL WASTE ! AMOUNT 214 ~SSURE RELEASE o 4 ACUTE HEALTH o 5 CHRONIC HEALTH o 1 FIRE 0 2 REACTIVE , I r I I I I I ) I UNITS· 217 MAXIMUM DAILY AMOUNT 218 AVERAGE DAILY AMOUNT S-o'2- o ga GAL -42[ d CU FT 0 Ib LaS 0 In TONS . If EH5. amount mGSt bèìn Ibs. 216 219 STATE WASTE CODE 220 221 DAYS ON SITE 222 223 STORAGE CONTAINER (Check alt thai appty) o a ABOVEGROUND TANK Db UNDERGROUND TANK DC TANK INSIDE BUILDING o d STEEL DRUM STORAGE PRESSURE o a AMBIENT De PlASTICINONMETALLlC DRUM Of CAN o g CARBOY o h SILO o i FIBER DRUM OJ BAG o k BOX ~UNDER o m GLASS BOTTLE o n PlASTIC BOTTLE o 0 TOTE BIN o P TANK WAGON o q RAIL CAR o r OTHER 224 STORAGE TEMPERATURE BOVE AMBIENT o ba BELOW AMBIENT o as ABOVE AMBIENT o ba BELOW AMBIENT o c CRYOGENIC 225 DYes 0 No 228 2 230 231 DYes 0 No 232 233 3 I 234 235 OYesONo 236 237 4 238 239 DYes 0 No 240 241 5 242 243 o Yes 0 No 244 245 UPCF (7/99) S:\CUPAFORMS\OES2731.1V4.wpd