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Home My WebLink AboutBUSINESS PLAN 7/17/2007i H ~ HAL I. SHAPIRO ~ 3403 WILSON ROAD ~~ el s F,'' ~~ SHAPIRO DDS HAL I SiteID: 015-021-002304 Manager HAL I SHAPIRO Location: 3403 WILSON RD City BAKERSFIELD BusPhone: (661) 833-9966 Map 123 CommHaz Minimal Grid: 11D FacUnits: 1 AOV: CommCode: BFD STA 07 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact / Title Emergency Contact / Title HAL I SHAPIRO DDS / OWNER / Business Phone: (661) 833-9966x Business Phone: ( ) - x 24-Hour Phone (661) 663-8303x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact HAL I SHAPIRO Phone: (661) 833-9966x MailAddr: 3403 WILSON RD State: CA City BAKERSFIELD Zip 93309 Owner HAL I SHAPIRO DDS Phone: (661) 833-9966x Address 3403 WILSON RD State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ENT°D J U L 1 ~ ~Q~7 =~'.^d e~ rr, i~,quiry of thoss indivic~~la!s r€~~kr„t~G~!o for ;;t~taini,, the i~fo~iration, !certify un~ei- h:SE~a~ty Ji !aN1 that ~ have ;personalty e-~~~r`?+~,~%d ~:nd am farri?iar vrith the ;^formation uhn~ie=:~c; _; ;;; t~slis~;°°e tha information is true , aCCUr3tt?, ;r- i ~ )Rlp!et? _ s e ~ Signature Da -1- 07/16/2007 . i ~r~ a' F SHAPIRO DDS HAL I SiteID: 015-021-002304 ~ ~ 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- 07/16/2007 ~',- -3- 07/16/2007 .~ i F SHAPIRO DDS HAL I ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit DARKROOM STATE TYPE PRESSURE Liquid TWaste ~ Ambient SiteID: 015-021-002304 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# i TEMPERATURE CONTAINER TYPE Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 5.00 GAL 1.00 GAL nr~~~ucLVUJ ~.OMPONENTS %Wt. RS CAS# Silver No 7440224 t1HG1iKL liJ JP~J J1~181V1J TSecret RS BioHaz Radioactive/Amount- EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/16/2007 ~:. F SHAPIRO DDS NAT, I SiteID: 015-021-002304 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ Ay Clll.Y 1vV11111.0.1.1 V11 i,-, lrlll~J1VYCC 1VV 1.11. ~ ~V0.1.U0.1.1 V11 Public Notif./Evacuation Emergency Medical Plan -5- 07/16/2007 ~ _z F SHAPIRO DDS HAL I SiteID: 015-021-002304 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention Release Containment Clean Up 02/27/2007 IN CASE OF SPILL, AREA WILL BE DRIED AND FIXER WILL BE TRANSFERRED TO NEW CONTAINER. IT IS CURRENTLY STORED IN SELF-CONTAINED LEAKPROOF CONTAINER AND PICKED UP EVERY TWO WEEKS BY OUTSIDE COMPANY WHO SERVICES THE WASTE CONTAINER. Vl,i1C1. KCSVI.LIC:C I~C:l.1Vdl.1Vi1 -6- 07/16/2007 -~_ _ ~, - F SHAPIRO DDS HAL I SiteID: 015-021-002304 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~JCC:1d1 riclGcLIU~ Utility Shut-Offs 02/27/2007 ALL SHUT-OFFS ARE OUTSIDE AT MAIN. THIS IS ONLY ONE UNIT IN A MULTIPLE TENANT STRIP MALL. NO SHUT-OFFS INSIDE UNIT. Fire Protec./Avail. Water 02/27/2007 SPRINKLER SYSTEM. Building Occupancy Level 02/27/2007 7 EMPLOYEES -7- 07/16/2007 _q ~~~ F SHAPIRO DDS HAL I SiteID: 015-021-002304 ~ Fast Format ~ ~ Training ~ Overall Site ~ ~ Employee Training 02/27/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES TRAINED IN EVACUATION PLAN AND LOCATION OF FIRE EXTINGUISHERS. rage Bela for r~uLUre use neiu ic~r ruLUi~ use -8- 07/16/2007 ~' ,; SHAPIRO DDSttHAiL I SiteID: 015-021-002304 Manager '_ r~°I! S~P~PO BusPhone: (661) 833-9966 Location: 3403 WILSON RD Map 123 CommHaz Minimal City BAKERSFIELD Grid: 11D FacUnits: 1 AOV: CommCode: BFD STA 07 EPA Numb: SIC Code:8021 DunnBrad: Emergency Contact /_ Title Emergency Contact / Title HAL I SHAPIRO DDS / GW N~{Z - / Business Phone: (661) 833-9966x Business Phone: ( ) - x 24-Hour Phone (661) 663-8303x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact HAL I SHAPIRO DDS Phone: (661) 833-9966x MailAddr: 3403 WILSON RD ~ State: CA City BAKERSFIELD Zip 93309 Owner HAL I SHAPIRO DDS Phone: (661) 833-9966x Address 3403 WILSON RD State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif~d: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN L?sed on my inquiry cf those i~~diviG~.ai; responsible for obtaining the information, ! c~rtity .- under penalty of la~ri teat i have personally examined and am familiar with the information ENS ~~B submitted and believe the information is true, 2 ~ 2007 accurat ,and co plete. a I~la~ Signatur Date -1- 02/06/2007 F SHAPIRO DDS HAL I SiteID: 015-021-002304 ~ ~ 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 Minl -2- 02/06/2007 -3- 02/06/2007 F SHAPIRO DDS HAL I SiteID: 015-021-002304 ~ ~ 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 ~mbRentURE ~ TAE~MPeRATURE ~STOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 5.00 GAL 5.00 GAL 1.00 GAL -- ru~~.ytcLUU~ ~ui~irulv~ly l °sWt . RS CAS# Silver No 7440224 t1HGHKL 1~JJ~5J1~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 02/06/2007 F SHAPIRO DDS HAT, I SiteID: 015-021-002304 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ s-~yency 1VV1.111Cd1.1Vi1 Employee Notif./Evacuation rUlJ11C: 1VV 1.11 ~ L~VCI I: UCI 1.1 V11 emergency i~ieulcdl r1d11 -5- 02/06/2007 b ,t F SHAPIRO DDS HAT, I SiteID: 015_-021-002304 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ _~ ncicaac ri.cvcii~.iVii Release Containment I.l CQ11 V~J. , T~ C'A~f o~ ~ p~) ~ ~ RJf9 w~)~ ~i~ c~v~i ~c~ '~ ~ "~ S Cv~'r-Pv~~~~ ~' S~~'c1 )~ S--pl ~ (`rhfeilh fc~ 1 ~~ ~ c~ p P ~,~ b d ~~ s. c~ ~ c ~ m A ~y ~ ~ D 5~ f v I cis 'I ~^-r `^~q S~'e / C °h ~- ~n ~ o-- Vl.i1Cl K~.S'VUIC:C 1-1C:l.1Vdl.1Ui1 -6- 02/06/2007 ,~. F SHAPIRO DDS HAL I SiteID: 015-021-002304 ~ ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aNc~idi nd~diu~ v1.1111.y .7ilUL-VLLS X11 s~crt o~~`s ~iP a~~5~~2 ~`~ ~q-~ ~i5 1 S ah~ Pn~ vn~~ ern !~(~(~~rf~~ ~~~ ~n~' ~~ S~ ~ 5 p ~-~S jhs~`c1{ ~h~~, ,_ r 11C..r1Vl.Cl.../tiV dll Wdl.Cl ~~~~~~~5 ~1G5 5 .riv~k~~r S~~+P~'- a LL11 U1111~. VI: I: U~Jd11C:y LCVC1-- c~su~~~ .Sfv~v~ P~n~,Qy~~s 1 ~ +m~~- ~~~~s ~ P -~= 02/06/200 F SHAPIRO DDS HAL I SiteID: 015-021-002304 ~ ~' Fast Format ~ ~ Training Overall Site ~ r~Ul~JlUyee 1 i d1i1111C~. i .~ ~ ~~~ 1°1P~ ~ f~~h~r 1 ~^ ~~ 1 ~d rol~ teh a f 'e VRCv~~~h ~9 ~ -~c~~e ~~~~~c,l,~rs f rdye ~ nclu l.vi r u~uiC vac vela l:c~r r u~ure use -8- 02/06/2007 qc, '.T + SHAPIRO DDS HAL I ___________________________________ SiteID: 015-021-002304 + Manager BusPhone: (661) 833-9966 Location: 3403 WILSON RD Map 123 CommHaz Minimal City BAKERSFIELD Grid: 11D FacUnits: 1 AOV: CommCode: BFD STA 07 SIC Code:8021 EPA Numb: DunnBrad: +______________________________________________________________________________t Emergency Contact / Title Emergency Contact / Title HAL I SHAPIRO DDS / / Business Phone: (661) 833-9966x Business Phone: ( ) - x 2 4 -Hour Phone ( b61 ) 663' _ 83 03 x 2 4 -Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact HAL I SHAPIRO DDS Phone: (661) 833-9966x MailAddr: 3403 WILSON RD ~ State: CA City BAKERSFIELD Zip 93309 Owner HAL I SHAPIRO DDS Phone: (661) 833-9966x Address 3403 WILSON RD State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~~ 5 ~~ ~ o {~ \ 5~ based on my inquiry of those individuals ~~~ `~~'V ®2 20 responsible for obtaining the information, I certify ~6 under penalty of law that I have personally examined and am familiar with the information submit d and believe the information is true, accur• t ., nd plate. - ~ 2 5 ~3~~~ 5ignat a Date +_______________#E______________________________________________________________+ -1- 05/22/2006 '' UNIFIED PROGRAM INSPECTION CHEC SECTION 1 • Business Plan and Inventory Pr ~q~5~ LIST ~ - - gram ~,~~ K ~~irr ~ o BASERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPEC ION DAT NSPECTION TIME sur Srk ~,~ -~~ ~ s ~~.~ ~ ~~~ ~~ ADDRESS ~ SdN yQN~IJO. +~~ (~~A 33 (~ OOFE OYEES ~ ~ ~ ~ L d . , FACILITY CONTACT ~ USINESS ID NUMBER ,5_oz,_ a~ ,~ ~~. Section 1: Business Plan and Inventory Program ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (e=eonip1i~) OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIt1@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OFQUANTITIES -- `~r 2007 ~ ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~A n c o.Jc~l S ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ ~ ^ FIRE PROTECTION SITE DIAGRAM ADEQUATE & ON HAND '~ it 2~ rx'f': is y~ • S L:, ~ ~ ~1}'-' ~ So, v+ c ~ ANY HAZA"RDOUS WASTE ON SITE? .YES ^ NO EXPLAIN: ~ °~ k~ ~ k ~ r -- --- QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (881) 928-3879 1 ~ ' Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Station 8 Business Site/School Site Respons' a arty (PI White -Prevention Serviees Yellow -Station Copy Pink - Buainesa Copy FD2049 (Rw. 1M105) .~. '; ~0~5' `~~~~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~4 b OFFICE OF ENVIRONMENTAL SERVICES a~ , . ~ ~ UNIFIED PROGRAM INSPECTION CHECKLIST ~_~~,~~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME KA ~- S \~ A~P I dZy ~~ S INSPECTION DATE~~ ~ D Section 4: Hazardous Waste Generator Program EPA ID # ~ ho •-- ,O .I' ^ Routine ~ Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~~tQ ;~, Authorized for waste treatment and/or storage S~o• o c,,. ~~ 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 9'~/~( Secondary containment provided Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste ~ / Proper management of lead acid batteries including labels N/~ Proper management of used oil filters N / Transports hazardous waste with completed manifest Sends manifest copies to DTSC 4 -+- ~ r r o v^ Retains manifests for 3 years ~ ~ ~ O w `Y 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=vtolat~on Inspector: ~ G ~~-t~- • ••. ~" Office of Environmental Services (661) 326- 979 White -Env. Svcs. l - usiness Site Responsible Party Pink -Business Copy