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Home My WebLink AboutBUSINESS PLAN`~ P ~ Bakersf eld Fire Dept. UNIFIED PROGRAM INSPECTION CMEC9tCLIST Environmental Services ~~ ~,~ts:~ ~ - "~~~°'~ ~ 900 Truxtun Ave., Suite 210 SECTION 1 Business .Plan and Inventory Program Bakersfield, CA 933~j}EC Tel: (661)_326-3979" _? 1,~~~ FACILITY NAME INSPEC ION D TE INSPECTION TIME i303 ( Jr Cl-F~u - n-~? S --- ~ ~~za d~ _ _ . -- ADORESS ~ PHONE No. No. of Employees nrtv~.l /~ ~~o:~ cJ ~ 3ZZ-~z2 ------------------ - --- -------------- ..__..._.. - --- ------- ---- __ -- ---- . - ~----- --- .. - _ . __ . -- ----- ---- -L----- - . - ---- ---- - - FACILITYCONTACT Business ID Number i 15-021- Section 1: Business Plan and Inventory Program i ^ Routine ~6~nbined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-In Ion C V \ V=Vio atlonnce ~ OPERATION COMMENTS `~ ~ ~ ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ---- - ~ ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ ~ VERIFICATION OF INVENTORY MATERIALS `c1'/1~ (L tt ~t~~ ----- -- --- --- ------- -- ------- _..._ ____ .. t .._._._ __ - --- - _ .. _. __. .. _ _ .. ^ ^ VERIFICATION OF QUANTITIES ^ ^ VERIFICATION OF LOCATION ~ ~~S~AE ~/~C:RFkJ~\ ^ ^ PROPER SEGREGATION OF MATERIAL - --- -- -- ^ ^ VERIFICATION OF MSDS AVAILABILITYE J ^ ^ VERIFICATION OF HAT MAT TRAINING p A ^ ---- ^ ---- VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES - -.... - - - -- - ---------- -------- --------------- ~ 'f - /' 1 ... _ - ~-- _.._... - - -- - _... sue} l,J------._~.. _......__. t ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS- PROPERLY LABELED ^ ^ HOUSEKEEPING I - ^ ^. FIRE PROTECTION ~ ~- ^ ^ _ --- SITE DIAGRAM ADEQUATE Et ON HAND - I---- 1 ~' ~ ' 1 1 1 ANY HAZARDOUS WASTE ON SITE: EXPLAIN: AYES ^ No ~, ~` Name Date Time `~ BOBI V. CHAD, D.D.S. 3605 Union Avenue Bakersfield. CA 93305 (661) 3222117 QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (001 ~ 320-3979 Inspector (Please Print) Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow - Stetgn Copy Busi ess ite Responsible PaAy (Please Print) ~ B N Pink -Business Copy ~ ~F, - . ~' Tai- CITY OF BAKERSFIELD FIRE DEPARTMENT b OFFICE OF ENVIRONMENTAL SERVICES y UNIFIED PROGRAM INSPECTION CHECKLIST ~k•E'"~gti~°~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME ~J~ 1 y" C ~y . ~ ~ S Section 4: Hazardous Waste Generator Program ^ Routine ~-. Combined ^ Joint Agency INSPECTION DATE ZS aS EPA ID # ~( '~ ^ Multi-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided P(,~L (,~n,,~~.n~ Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal ~.-~,v,u~„a,wc v - v wiaugn Inspector: ~ 1 ~ ~~~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. I Bu ne Site Responsible Party Pink -Business Copy B - ..,:,..:, .~ ~ . a .~...,- CI-TY 01~ 13AKERSFIELD . OFFICE OF ENVIRONMENTAL SERVICES E 1715 Chester Ave., CA 93301 (661) 326-3979 _' ~ ~ HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION ,~~,'CW ^ ADD ^ OELETE ^ REVISE 1. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doins Business As) - CHEMICAL LOCATION j ~5 ' ~E r1M K ~Mn ~.^----- - -i -~ . /~~ -.. - - - ~. -MAP # o trona -- - ~ - - - - V' -- FACILITY ID # (' ~ ! (P 0 I ~ "~ ~ I II. C~1EMiCAL INFORMATION CHEMICAL NAtv1E (.,~AS'T~ .~ x~,2. COMMON NAME CAS # i FIRE CODE HAZARD CLASSES (Complete if requestetl by local fre chief) (one loan per mafeRal per building or area) Page _ of _ 20t CHEt.tICAL LOCATION ^ Yes ^ No 202 CONFIDENTIAL (EPCRA) 203 GRID # (optionaQ - ~ ----- -~- 20a - 205 TRADE SECRET ^ Yes ^ No 206 L` Subject to EPCRA. refer to instruaiors zo7 -- EHS' ^ Yes ^ No 208 209 •If EHS is'Ya.' all amomts below must lx in lbs. 270 --- -------- - ----~- - _ - - -~ - -- - - - - - -- -- -- ------ CURIES 2t3 TYPE ^ p PURE ^ MIXTURE ~W WA£ .. R-.!~IOACTiVc ^ Yes ^ No 272 PHYSICAL STATE ^ s SOLID ~yIQUID ^ g G,',S 2,a LARGEST CONTAINER FED HAZARD CATEGORIES ^ 7 FIRE ^ 2 REACTIVE ^ 3 PRESS ;RE ~:ELE~. SE I_ %. q :U~-E HEALTH [~5 CHRONIC HEALTH (Check all that apply) _ _ _- _ .- ..-_-______ ANNUAL WASTE ---_ -- -- - - - - ~~ 217 - ;d4XIMUA,7 - 218 ~ s P.VERAGE 5- 279 ~ STATE WASTE CODE NT O AMOUNT DAILY AMOUNT DAILY AM U UNITS" ~.ga GAL ^ d CU FT ^ Ib LBS i~ to TONS 227 I DAYS ON SITE i ~ ' If EHS. ama:nt must be in lbs. ' STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR (Check a!1 that apply) ^ b UNDERGROUND TANK ~^. f CAN ~ v j BAG / `PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN ^ d STEEL DRUM Li h SILO - ^ I CYLINDER ^ o TANK WAGON STORAGE PRESSURE ~a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOVJ AMBIENT STORAGE TEMPERATURE ~ gMBIENT ^ as ABOVE AMBIENT ^ b3 BELOW AMBIENT ^ c CRYOGENIC ~ %\/y~' > HAZARDOUS COMPONENT ---_-_ I EHS `. CAS # 7 226 ~ 227 ~ ^ Yes ^ No 228 2 230 ~ 237 ^ Yes ^ No 232 3 234 ~ - _- 235 ^ Ye5 ^ No 236 a 238 I I 239 ' ^ Yes ^ No 240 ~ 5 i 242 . -- 2"3 ~ ^ Yes ^ No 244 III. SIGNATURE 275 2i6 220 222 223 224 225 229 233 237 tat 245 -PRINT NAME 8 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 4 os . ' _ E R S P 1 U PIRA ABTM T UPCF (7/99) S:\CUPAFORMS10ES2731.TV4.wpd ~. aca63 CHAU DDS BOBI V SiteID: 015-021-0019€30 Manager HOLLY FRAKER Location: 3605 .UNION AVE City BAKERSFIELD BusPhone: (661) 322-2117 Map 103 CommHaz Minimal Grid: 20A FacUnits: 1 AOV: CommCode: BFD STA 04 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title BOBI V CHAU DDS / OWNER PRISCILLA MUNOZ / Business Phone: (661) 322-2117x Business Phone: (661) 322-2117x 24-Hour Phone (661) 706-2428x 24-Hour Phone (661) 392-1645x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Haz~~ ~/, CH~V~ C.D.s. React Contact _ Phone: (661) 322-2117x - MailAddr: 3605 UNION AVE State: CA City B.i(~,KERSFIELD ~ Zip 93305 Owner BOBI V CHAU DDS Phone: (800) 222-3120x Address 3605 UNION AVE State: CA City BAKERSFIELD Zip 93305 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~N~ MAR ~ X007 ~3ased on my inquiry of those individuals responsible far obtaining the information, I certify under penalty of iaw that I have personally examined and am familiar with the information " submitted and believe the information is true, accurate, and complete. ~ c ~~ ~ ~ ~ Si nature ~ ~ ~ ~~ g D to -1- 01/29/2007 T ~ F CHAU~DDS BOBI V SiteID: 015-021-001960 ~ ~ 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 5.00 GAL Min -2- 01/29/2007 -3- 01/29/2007 r. F CHAU DDS BOBI V SiteID: 015-021-0019E30 ~ ~ 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: ------- DARKROOM CAS# Liquid TWaste -~mbient~E ~ AmbientT~E ~ PLASTICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 5.00 GAL HA ZARDOUS COMPONENTS %Wt. RS CAS# Silver No 7440224 rltiL~ti[C1/ tiJ JP~J J1"1rr1V 1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 01/29/2007 r F CHAU DDS BOBI V SiteID: 015-021-001980 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/20/2006 ~ 911 AND/OR MEDICAL DOCTOR. Employee Notif./Evacuation 08/12/1999 EACH EMPLOYEE HAS A SPECIFIC AREA FOR EMERGENCIES, MAPS & EMERGENCY PHONE NUMBER ARE POSTED IN HALLWAY AND AT EACH PHONE. Public Notif./Evacuation 08/12/1999 OFFICE MAP WITH EXITS POSTED VISIBLE IN HALLWAY. Emergency Medical Plan 08/12/1999 EYE WASH STATION & FIRST AID KIT AVAILABLE. 911 OR MEDICAL DOCTOR, PHONE NUMBER POSTED AT EACH PHONE. -5- 01/29/2007 F CHAU DDS BOBI V SiteID: 015-021-0019F30 ~ ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 02/07/2006 ~ ENCLOSED IN A SEALED CONTAINER Release Containment 09/29/1999 SPILL KITS AVAILABLE IN OFFICE. Clean Up 10/20/206 METHODS OF DISPOSAL OF SPILLED SOLIDS OR LIQUIDS MUST FOLLOW FEDERAL & STATE LAWS, SUCH AS, DO NOT FLUSH OR INCINERATE. v1~11C1 1CC~VUiUC HC: 1.1 Vci 1, 1CJII -6- 01/29/2007 F CHAU DDS BOBI V SiteID: 015-021-0019E30 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _, .~Nc~..Lai nac.aiu~ Utility Shut-Offs 10/20/2006 A) GAS - BACK RM IN OFFICE B) ELECTRICAL - BREAKER BOX IN HALLWAY C) WATER - FRONT OF BLDG IN FLOWER BED D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 10/20/2006 PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - UNION AVE. Building Occupancy Level 02/07/2006 6 EMPLOYEES -7- 01/29/2007 F CHAU DDS BOBI V SiteID: 015-021-001980 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/20/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: TRAINING OF ALL EMPLOYEES IN GOOD SAFETY AND HEALTH PRACTICES, SAFEGUARDS TO THE MAXIMUM EXTENT POSSIBLE. CONDUCTING SAFETY INSPECTIONS TO FIND AND ELIMINATE OR CONTROL HAZARDS AS WELL AS UNSAFE WORKING CONDITIONS. rctyC ~ Held for Future Use nclu iui ruuuic u5~ -8- 01/29/2007 + CHAU DDS BOBI V _____________________________________ SiteID: 015-021-001980 + Manager HOLLY FRAKER BusPhone: (661) 322-2117 Location: 3605 UNION AVE Map 103 CommHaz Minimal City BAKERSFIELD Grid: 20A FacUnits: 1 AOV: CommCode: BFD STA 04 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title BOBI V CHAU DDS / OWNER / Business Phone: (661) 322-2117x Business Phone: (661) 322-2117x 24-Hour Phone (661) 706-2428x 24-Hour Phone (661) 392-1645x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact Phone: (661) 322-2117x MailAddr: 3605 UNION AVE State: CA City BAKERSFIELD Zip 93305 Owner BOBI V CHAU DDS Phone: (800) 222-3120x Address 3605 UNION AVE State: CA City BAKERSFIELD Zip 93305 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives : ~~~~ ~ j~i~j~ ~~~~ PROG A - HAZMAT i~ PROG H - HAZ WASTE GEN ~ ~r-~L"i ~/Cl ~~~LC~'~ ~ Based on my inquiry of those ind~ i~Ceafy responsible for obtaining the informatioe,rsonally under penalty of law that { have P exam,.lII~d and ~ oufaav~ Ithe Wnformationo is true, ~ ~~~~ Date BAR ~ 5 zo os -1- 03/06/2006