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Home My WebLink AboutBUSINESS PLAN (2)ii CENTRAL CARDIO l 2110 TRUXTUN AVE f II 1 II '`~~D p~~E' CITY OF BAkERSF1EI.D FIRE DEPARTMENT OFFICE OF ENVIRONMF,NTAL SERVICES ` , UNIFIED PROGRAM INSPECTION CHECKLIST wa'"Q~,, 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 OCj 2 ~ ~0~ FACILITY NAME flo ~ INSPECT[ON DATE IO '2 2 - 03 _ ADDRESS u tr o~v PHONE NO. ~ 2 ~r - ,~ Sl'~ FACILITY CONTACT / °v •' 1 BUSINf:SS ID NO. 15-210- 00 7 J INSPECTION TIME NCIMBER OF EMPLOYEES - Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^Muhi-Agency [~ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate 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 Q-~~ ~- Verification of abatement supplies and procedures /,~jj-~ O a ~ Emergency procedures adequate iv - ~ 7- G 3 ~ rn ~ ~ ~ Containers properly labeled v 5 d O ;~ Housekeeping /~ ~~~ ~ 1~ Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ~ Yes ^ No ~~ Explain: ~, GQC= ~ Questions regarding this inspection? Please call us at (66l) 326-3979 ~ usine S~ Responsible Party White -Env. Svcs. Yeltow - Ststion Copy Pink -Business Copy Ii1SpeCtOf: . Prevention- Services - UNIFLED PROGRAM INSPECTION CHECKLIST ' ~ _ e >: R 5 r , n 900 Truxtun Ave.; Suite 210 ~..,.~~m._~=.. ~.~.:~~..a~ ~4~; > .. ~... _ _ _._~-~:..~_~ ~ :-_~ ~ ~.- ~- - ~iRF Bakersfield, CA 93301 SECTION 1: `Business Plan and Inventory Program "R"" Tel.: (661) 326-3979 • ~ Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME r `c~1~+~ilL•gl. C A ~~~ o-L oG~ l/ f'Vt ~s A (tr , ~n+ 1 c 10 ~~ v6 13 4 ~ ADDRESS ~ PHONE NO. - NO OF EMPLOYEES '~\lu Ti¢,vxTtin~ A~,~ )~~23-413~Q ~ja FACILITY CONTACT BUSINESS ID NUMBER -Ssr, >j~'~ ~ v o _ -~ 15-021- ~(J Z Z ~l • - - - -- --- Section 1: Business Plan and Inventory Program ~(~(~ 1 ^ ROUTINE ^ COMBINED ^ JOINT AGENCY' ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (C=Compliance OPERATION V=Violation COMMENTS ~^ APPROPRIATE PERMIT ON HAND ~ LY ^ BUSIfteSS PLAN CONTACT INFORMATION ACCURATE ^ - ~ VISIBLE ADDRESS ^ CORRECT OCCUPANCY J ^ VERIFICATION OF INVENTORY MATERIALS 6 , ~~1 ~r ~cl ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION , ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY C~/ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ .EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING - ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 • ~"~ zo -~" - , ~ Inspector (I se Print) Fire Prevention/ 1~' In /Shift of Site/Station # Busin e / Respons(ib arty (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ^ YES L~10 ~~ N CI°iECMCLIST `'~ UNIFIED PROGRAM 1NSPECTiO -~ SECTION 1 Business Plan and Inventory Program ,mil • ,~ r1 U Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661) 326-3979 _ FACILITY NAME ,~ CTION D TE NSP ON TIM ~ ~ ~ °~!"G ..Ld..d °~.. f._.. _ ADDRESS PHONE No. No. of Employees -_Z ~ i o-- --._. _~r~__ _ -- . __~~---- -. _._ _ _ _ --~- _ _ _ _ _ _. _ _- - - z-~^8~~y_ _ 3~---- --_. _. FACILITYCONTACT- Business ID Number ./eh nr - T~ 15-021- Section 1: Business Plan and Inventory Program 1~Routine O Combined ~ Joint Agency OMulti-Agency O Complaint ~ Re-inspection ANY HAZARDOUS WASTE ON SITE7: ^ YES ~NO EXPLAIN: •_ QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (661 ~ 3Z6-3979 Inspector (Please Pnnt) Fire Prevention tst-In/Shift of Sde White -Environmental Services Yellow • Stelan Copy n s it espo ble aAy (Please Print) Pink • Business Copy o, v - ,~ _., ;~ CENTRAL CARDIOLOGY MEDICAL CLINIC Manager : ~er~~n~~+r~`ra-~/b Location: 2110 TRUXTUN AVE City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: SiteID: 015-021-0022'71 BusPhone: (661) 323-8384 Map 102 CommHaz Low Grid: 25D FacUnits: 1 AOV: SIC Code:8011 DunnBrad: Emergency Contact / Title Emergency Contact / Title TROY KIRK ! JENNIFER BRAVO /~.~1-ri1r1iS`f'~Zi~Df' Business Phone: (661) 323-8384x Business Phone: (661) 323-8384x15 24-Hour Phone (661) 589-8542x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth De1Hltli ............... Contact. _: TROY KIRK - - ° - - Phone : ( 6 61)~3~23 - 83 84x~ - - MailAddr: 2110 TRUXTUN AVE State: CA City BAKERSFIELD Zip 93301 ............. Owner TATSUO ISHIMORI MD Phone: (661) 823-8384x Address 2110 TRUXTUN AVE State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ENT'D F E B 2 6 2007 Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of lavr that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~ ~-l l3 ~~~- . i ature Date -1- Ol/29/~007 F CENTRAL CARDIOLOGY MEDICAL CLINIC SiteID: 015-021-002271 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit 1~~P OXYGEN F IH DH G 200.00 FT3 Lbw \ , -2- O1/29/~007 -3- O1/29/~007 .. F ' p CENTRAL CARDIOLOGY MEDICAL CLINIC SiteID: 015-021-002271 ~ ~ 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: PORTABLE CARTS CAS# 7782-44=7 STATE T TYPE PRESSURE ~~ TEMPERATURE ~~ CONTAINER TYPE ~GaS I Pure Above Ambient I Ambient I PORT. PRESS. CYLINDER I AMOUNTS AT THIS LOCATION - Largest Container Daily Maximum I Daily Average 24.00 FT3 200.00 FT3 200.00 FTC nt~~rjtcLwS uvi~irulv.~lv~l~~ _ -- - ~ - ~ 100 . 00 .~_ _ _ - Oxygen, Compressed - ~ - - " "~ ~- _. No 7782~~7 nx~tatcL r~55~aat~i~iv-1~5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MC1 No No No No/ Curies F IH DH / / / Levu -4- O1/29/Z007 h F CENTRAL CARDIOLOGY MEDICAL CLINIC SiteID: 015-021-002271 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 10/20/20175 I CALL 911 Employee Notif./Evacuation 08/28/20173 EVACUATION ROUTE POSTED IN EVERY ROOM. Public Notif./Evacuation ~ ~ S.~'~ ~-~R.~ Jo- P~~ ~~ o~-~t.~ P~LLLCLyCil(ry 1"1CCi1C;dl Y1cLii -5- O1/29/~007 F CENTRAL CARDIOLOGY MEDICAL CLINIC SitelD: 015-021-002271 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention ~o ~~A~, c~~~~ ~ Release Containment 08/28/2073 SMALL CONTAINERS O Clean Up 08/28/20173 SPILL KITS V1.11CL 1CCSVULC:C HUl.1Vdl.lVil -6- Ol/29/~007 ~ CENTRAL CARDIOLOGY MEDICAL CLINIC SiteID: 015-021-002271 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ Special Hazaras Utility Shut-Offs 01/29/2007`7 - - - - ----- - - - - - -r----~ ELECTRICAL - MAIN N SIDE OF BLDG NEXT TO STEPS GAS - SHUT-OFF VALVE W SIDE OF BLDG Fire Protec./Avail. Water WATER SE CRNR OF BLDG 01/29/2007 1J lLl ll1111y Vt. l~{.L~10.111r ~/ LC V C1 -7-. Ol/29/~007 .. . i .` F CENTRAL CARDIOLOGY MEDICAL CLINIC SiteID: 015-021-0022'71 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/20/20(76 ~ BRIEF SUNIMARY OF TRAINING PROGRAM: OSHA COMPLIANCE AND TRAINING ~~no ~ ~~~ nC1u 1VI rUl..IALC U5C nciu iui ruLUi~ use -8- 01/29/2007 :, . ...~~ GG C~e`rtrt.~.e Cardiology Memorandum To: ALL CCMC STAFF MEMBERS From: JENNIFER BRAVO, SAFETY OFFICER Date: 2/i/2oo~ Re: FIRE EVACUATION PLAN _ _ IN CASE OF FIRE: i. Sound the Alarm. Announce overhead "CODE RED, CODE RED, CODE RED. There is a CODE RED in (location of the fire). RED Team Respond." (repeat) . Ca119-1-1. 2. Leave the area quickly, closing doors as you go, to help contain the fire and smoke. 3. Go to the nearest exit that is not blocked by fire. 4. Heat and smoke rise, leaving cleaner air near the floor. If you must escape through smoke, crawl low. 5. Test doors before you open them. Kneel or crouch at the door, reach up as high as you can with the back of your hand and touch the door, the knob, the space between the door, and its frame. If the door is cool, open it cautiously and continue along your escape route. 6. Follow directions from Red Team and security personnel. Once outside, move away from the building, out of the way of fire fighters. Everyone should gather in the north parking lot, near i7th Street, so a head count can be made to determine if everyone escaped safely. Remain outside until the fire department says you may go back in. ~~ ~~ __ C?e~~Gr.~.e Cardiology Memorandum To: ALL CCMC STAFF MEMBERS From: JENNIFER BRAVO, SAFETY OFFICER Date: 2/i/2oo7 Re: , , _._ _ BOMB THREAT AND/OR SUSPICIOUS PACKAGE , _. _ _--_ Please keep the following safety protocol information at your work station for your future reference. Thank you. In case of the following scenario, please notify your immediate Supervisor or Safety Officer immediately. BOMB THREAT: LOG Time• Date• Person taking call• QUESTIONS TO ASK CALLER What Time is the package bomb set to go oft`? Where is the package/bomb located? What is it in? How is it Packaged? What type of Explosive? What type of detonation device? Why this place or office? CALLER IDENTIFICATION: What is your name? What group or association do you belong to? Listen for: Male or Female Accent: Ethnic Group: Asian, Black, Caucasian, European, Hispanic, Mideastern, other 1 ~ .g .. [~ Memo.Bomb Threat or Suspicious Package.03102005 SUSPICIOUS PACKAGE: STAFF (General Duty): Do Not Handle• Report immediately to your Supervisor or Safety Officer. ..-_-`SAFETYCOMMITTEEMEMBER:~'-`°- -`-- - ________~_ -= - DO NOT HANDLE. Try to determine ownership of package (patient, employee or other). If ownership is not established - IlVIIVIEDIATELY NOTIFY EMERGENCY RESPONSE SERVICE CALL 9-1-1. • Page 2