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HomeMy WebLinkAboutBUSINESS PLAN ?t. s`- _ ~i , DDS GREGORY E _______________________________ SiteID: 015-021-002336 + Ma ager Location: 3130 UNION AVE City BAKERSFIELD BusPhone: (661) 327-8473 Map 103 CommHaz Minimal Grid: 20C FacUnits: 1 AOV: CommCode: BFD STA 04 SIC Code:8021 EPA Numb : d©~ t;2~ ~`js DunnBrad ----------------------------------- -------- ---------------------------- Emergency Contact / Title Emergency Conta t / Title dt~ ~ MARY EGGERT / ~~., ~~ De,~~,.1 ~ss~- C w ~~a~~~~ / Business Phone: (661) 327-8473x~I~ Business Phone: (6Gt ) 3z7 - ~Yfi3x 24 -Hour Phone (Cg C) 6"~ - F~ x,uJ~ 24 -Hour Phone (~6/ )g7Z ~Q3 x +- _ Pager Phone (~~~ - x ~ & Pager Phone ( ,(~~. - x ------------ - ----------------+--------------React-------------------+ Hazmat Hazards: Contact MARY EGGERT Phone: (661) 327-8473x MailAddr: 3130 UNION AVE State: CA City BAKERSFIELD Zip 93305 Owner GREGORY E HANFORD DDS Phone: (661) 327-8473x Address 3130 UNION AVE State: CA City BAKERSFIELD Zip 93305 Period ~ to TotalASTs: = Gal Preparers ~~~ o~- ~ a .~m~ Q~S TotalUSTs: = Gal Certif'd: C~~~P~oo4 z~~q5 RSs• No ParcelNo : ~ t 5 O Z~ p ~~ 3G Emergency Directives: PROG H - HAZ WASTE GEN CN ~ ~U~V ~~ ~ ~ ~2DQ i ~~ 6 ~5 ~~ 0 c ~j~ Based on rn y inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information. is true, ac ate, and complete. l' Si t e°t _ , ~ ~jc Dat J -1- 05/1.7/2006 ~~ . ... ,. ., ~_ \ r~ r \ ,~' ~ S ~ ~ s ~ ~ ~~~ -~ 1. ~- ~ ~~~. 1 ~~ ~ Z s ~ ^ J~ .~ i ~ I' ' _ ~ ~~ i 1 ~ ~ , ~ ® _ ~~ ~ ~- i. I ~ { ~ ®~ ~. r ~, 1 ~~ ~ - '~ I o { ~~' ~ ~~ i r r _~ r J i ~r-- __ o _ ;~ O _ ~_ ~ ~ i-_ _ _ -_ . --- - --- _ - - - - - - _ _ ~ . ~ - ~L= r~'r"'~S~ 5t ~u~ y ~- 5~.~-~' 61r~nc~C~ O --- -- I ~n i . _i ClickFORMS Real Estate Appraisal Software by Bradford Technologies (800) 622-8727 ~~ - vvest view or the 5outn and fast End of Subject Building 03/0212007 11:13 6613277821 4 - - PAGE 01 HANF~RD DDS GREGORY E --~••- SiteID: 015-021-002336 gE;x. ; BusFhoTle: (661} 327-8473 Location: 3130 UNION AVE Map 103 CommHaz Minimal City BAKERSFIEI~D Grid: 20C FacUnits: 1 AOV: CommCode: BFD STA 04 EPA Numb: 000127895 SIC Code:$021 DunrtBarad Emergency Contact / Title Emergency Contact / Title MARY EGGERT / CHF DENTAL ASST GREGORY E HANFORD / OWNER Business PhoTle: (661) 327-8473x Business Phone: (661) 327-8473x 24~Hour Phone (661) 665-.1339x 2~4-Hour Phone (661} $72-0593x Pager Phone (. ) w x Pager Phone ( } - x Hazmat Hazards: ~ React Contact .: MARY EGGERT Phone: (661) 32'7-8473x MailAddr: 3130 UNION AVE State: CA City SAKERSFIELD Zip 93305 Owner' GREGORY E HANFORD DDS Phone: (661) 327-8473x Addx'ess 3130 UNION AVE State: CA City BAKERSF'IELD Zip : ' 93305 Period to TotalASTs: = Gal Frepaxer: TotalUSTs: = Gal Cex•tif ~ d: RSs : No ParcelNa: Emergency Directives: FROG H - HAZ WASTE GEN y t.i;i~i < _ _ "rte is':i ~`'1 .. .. 1>~ ..- .."-1r. : : ';. - `` .~.i . ~`,,..~, ~ ENTD MAR 2 2007 .r ATM I~Y1i~1 IP -1- 01/31/2007 ~- UNIFIE~ PROGRAM INSPECTION CHECKLIST ~` r/tI .SECTION 1: Business Plan and Inventory Program ~ BASERSFIELD FIRE DEPT Prevention Services 900 TYuxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPE TION ATE NSPECTION TIME G-rZG--~C.2 A+u oil 3 ~~~~'~ ADDRESS i 3a v.~n~o~ HONE NO. 327-~~t73 O OF EMPLOYEES FACILITY CONTACT USINESS ID NUMBER ,s_OZ,_ 2,3 Section 1: Business Plan and Inventory Program ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=Compliance OPERATION ~ V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIrt@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY - ^ VERIFICATION OF INVENTORY MATERIALS ^ . VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION T'11 w A ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ~ y ~ ZO®/ ^ VERIFICATION OF HAZ MAT TRAINING ~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES N ~ _ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? YES ^ NO EXPLAIN: ~~ ~ ~ rt ~ ~ I '~ - -- QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (881) 326-3879 Inspector (Please Print) Fire Prevention / 1° In / Shift of Site/Station # White -Prevention Servieas Yellow -Station Copy Pink - Buainese Copy FD2069 (Rev. lYd/OS- f ~` ~` ~~'~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~~ OFFICE OF ENVIRONMENTAL SERVICES • ~~ UNIFIED PROGRAM INSPECTION CHECKLIST '~ga~ 1715 Chester Ave., 3`d Floor, BalcersBeld, CA 93301 FACILITY NAME ~- ~ E ~ ~ ~- y 1 '~ ~~ ~ ~ Ds Section 4: Hazardous Waste Generator Program INSPECTION DATE ~ r ~ /~ ~ EPA ID # ~ E `~ ~ ~ ^ Routine ® Combined ^ Joint Agency ^Mulli-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number LAX E~ ~T 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 N~j~ Secondary containment provided Conducts daily inspection of tanks Used oil- not contaminated with other hazardous waste rV h Proper management of lead acid batteries including labels Jv Proper management of used oil filters N Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years ~+a~~Sar.. ~ ~ ?~~ Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal ~.-~.vuiNucuwc ~v - v IUlii[IOn Inspector: C~ ` £, ~ k,,,~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. Busi ess ite Res nsible -Party Pink -Business Copy [. =Y HANFORD DDS GREGORY E Manager MARY EGGERT Location: 3130 UNION AVE City BAKERSFIELD SiteID: 015-021-002336 BusPhone: (661) 327-8473 Map 103 CommHaz Minimal Grid: 20C FacUnits: 1 AOV: CommCode: BFD STA 04 EPA Numb: 000127895 SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title MARY EGGERT / CHF DENTAL ASST GREGORY E HANFORD / OWNER Business Phone: (661) 327-8473x Business Phone: (661) 327-8473x 24-Hour Phone (661) 665-1339x 24-Hour Phone (661) 872-0593x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact MARY EGGERT Phone: (661) 327-8473x MailAddr: 3130 UNION AVE State: CA City BAKERSFIELD Zip 93305 Owner GREGORY E HANFORD DDS Phone: (661) 327-8473x Address 3130 UNION AVE State: CA City BAKERSFIELD Zip 93305 Period ~~ 06 to 7 ~ ~7 TotalASTs : = s Gal Preparers ~_.~~~~.}~~,c-~~~tS TotalUSTs: = S Gal Certif'd: ? RSs: No ParcelNo : ~;,. g o' ~ o c~ Z 3~ Emergency Directives: PROG H - HAZ WASTE GEN Based on my inquiry of those individuals respensibie for obtai Wing the information I certify ~~~ ~~~ !~ , under penalty of IaG^. that I have personally examined and am familiar with the information submitted and believe the information is true, accur,~e and complete. _ '7 L ~ ~ ~ Sign< <ur, Date -1- 07/11/2007 F HANFORD DDS GREGORY E SiteID: 015-021-002336 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE FIXER R L 0.06 GAL Min -2- 07/11/2007 -3- 07/11/2007 ? ~ F HANFORD DDS GREGORY E ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit DARKROOM STATE TYPE Liquid TWaste SiteID: 015-021-002336 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# = PRESSURE TEMPERATURE CONTAINER TYPE Ambient ~ Ambient ~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 0.06 GAL 0.06 GAL t11-iGi-1tCUVUJ 1:V1~lYUlVr;1V'1-J °sWt . RS CAS# Silver No 7440224 t1HGHttL A7~~J51~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/11/2007 r F HANFORD DDS GREGORY E SiteID: 015-021-002336 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 06/02/2006 ~ SMALL OFFICE, 6 EMPLOYEES MAXIMUM. Employee Notif./Evacuation 06/02/2006 VERBAL Public Notif./Evacuation NOTHING PRESENT IN OFFICE TO WARRANT PUBLIC NOTIFICATION. 06/02/2006 Emergency Medical Plan 911, MEMORIAL HOSPITAL, PRIVATE PHYSICIAN AS NECESSARY. 06/02/2006 -5- 07/11/2007 :, F HANFORD DDS GREGORY E SiteID: 015-021-002336 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/02/2006 ~ 5-GAL CONTAINER FOR FIXER WITH FEEDING TUBE DIRECTLY ATTACHED TO FILM PROCESSOR. Release Containment 06/02/2006 TUB FOR 5-GAL CONTAINER. Clean Up 06/02/2006 PATTERSON DENTAL SUPPLY CO PICKS UP CONTAINER AND REPLACES WHEN WE CALL THEM. PATTERSON ENVIRONMENTAL CARE, LOS ANGELES BRANCH, EL SEGUNDO, CA 310-426-3100. Other Resource Activation 06/02/2006 NOTE: X-RAY PROCESSOR IS CONNECTED TO AN AUTOMATIC REPLENISHER - DISPENSES EXACTLY 7.0 OZ EACH MORNING WHEN PROCESSOR IS ACTIVATED. -6- 07/11/2007 ~~ '~ F HANFORD DDS GREGORY E _ SiteID: 015-021-002336 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~JCC,1d1 ridGdtC1~ Utility Shut-Offs 06/02/2006 GAS & ELECTRIC: SE CRNR OF BLDG Fire Protec./Avail. Water 01/31/2007 HYDRANT: NE PARKING LOT AT ALLEY ENTR Building Occupancy Level j6 EMPLOYEES ~, 06/02/2006 -7- 07/11/2007 .. F HANFORD DDS GREGORY E SiteID: 015-021-002336 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/31/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: PER GREGORY E HANFORD DDS AND MARY EGGERT. rage ~ Held for Future Use Bela zor ruLUre use -8- 07/11/2007