HomeMy WebLinkAboutBUSINESS PLAN
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GAMBRO HEALTHCARE--- \
7701 WHITE LANE #D J
--~ _ ----" --- --- -- -- - -- --- -----. - ------- - -------
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+ ~RO H~HCARR =================================== SiteID: 015-021-003030 +
Manager : ~
Location: 7701 WHITE LN D
City BAKERSFIELD
BusPhone:
Map : 123
Grid: 16A
(661) .396-7158
CommHaz : Low
Facunits: 1 AOV:
CommCode: BFD STA 09 SIC Code:
EPA Numb: DunnBrad:
+===================AA~~~J~~==1fn~~=A~n~======================================+
+===================~~r~dJ&~=~~~~=====================================+
Emergency Contact / /,_"~ '~eAJ.._~_. Emergency Contact / Title
~ ,/~\t ~ /
Business Phone: (661) 396-7 S8x Business Phone: () x
24 -Hour Phone : (~(pl) P-O?> -5Q(p1Jx. 24 -Hour Phone : () x
Pager Phone : () x Pager Phone : () X
+---------------------------------------+--------------------------------------+
I Hazmat Hazards: I
+------------------------------------------------------------------------------+
Contact : l1\ R VARNASI Phone: (661) 396-7158x
MailAddr: 7701 WHITE LN D State: CA
City : BAKERSFIELD Zip : 93313
+-----------------~------------------------------------------------------------+
Owner ~R VARNASI Phone: (661) 39C 71~8x'
Address : 7701 WHITE LN D State: CA ?;,.f't.f1}{
City : BAKERSFIELD Zip : 93313
+------------------------------------------------------------------------------+
Period to TotalASTs: Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
parcelNo:
+------------------------------------------------------------------------------+
Emergency Directives: ,
NkM e ~
PROG A - HAZMAT
PROG T - ABOVEGROUND STORAGE TANK
CAf1rN ~ I;J ~f(t iJ E:.5 S
(5)J -M9t-~P
~ (M!l(?f'l5f1fa.rL>
8'D'^-M
Based on my 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
sug.rnitt d believe the information is true,
/,accurate, an complete.
~/J-Dlo(o
Date' I
~u... Cfu11--
'Y11~
[NT'/) A PI?
o B ?D06
~rj)t
ItP\q
~
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+==============================================================================+
-1-
03/15/2006
s~ ~..-c,
UNIFIED PROGRAM INSPECTION CHECKLIST J I
SECTION 1 Business Plan and Invento;Y'p;~ I
""
,<
Bakersfield Fire Dept.
Environmental Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 931
Tel: (66D}~6~.39. f:JJ.2005
,._,~I~~;TIIY~~ ~:::~::~I~~..._
PHONE No. No. of Employees
.. Businessl[IN-umber--'" __u_ --- ...- .u.
I 5 - I - ,...Jt;-r....J
FACILITY NAME
__._~_..~~._ ._...._._..n.dU___... ,..
ADDRESS ~
__-1'2 0 L_...0J~~....~m._.........2___._..___..,..-.d.d-. ._u.....
FACILlTYCONTACT
Section 1 : Business Plan and Inventory Program
pLBoutine
o Combined
o Joint Agency
o Multi-Agency
o Complaint
c V
( C=Compliance )
V=Violalion
OPERATION
COMMENTS A
\'"'Z-"'3>""Jb
u, u----.-.-q.tJ
Cl Cl ApPROPRIATE PERMIT ON HAND
o LJ BUSINESS PLAN CONTACT INFORMATION ACCURATE
o LI', VISIBLE ADDRESS
LJ Cl CORRECT OCCUPANCY
t~l)~"~L),,",,_n<
,........... .. _I }_CO GtX.. ;e.t . _.
O___~_~~:~I~~C~~I~~.:>~ ~~~~!I~~.._.._.. u.... _._.. ~ L~~~I)~ ~~ ~rVlOJr-
9_._c:Jm.!'.~~~:~_SE~~~~~~~~Fn~~~E~I~~. ,.. .,... ,. j ..' .._.....
::'..~_.~~~I~~~~~~..~~~~~~~~I~A.~I~ITYE . _.._m.__". . ,..".~ .
i
., +.
9___c:J_.~_=~~I~~~I~~_~~~.~~~~.~ENT ~~_"~I~_~.AN~~~OCEOURES t.-.. .
j--.......
.~:~~~.::-~~~~~~~~~~...~,:.:::.:.....-~.:,-:::..':.~.::n:::.~_: ~'~'n_.:,.n '::.."':1.- .......,.". ,. ".
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..,..'d. .,.... .f-,-..........,......,
I
o O' VERIFICATION OF INVENTORY MATERIALS
rvlt.. .~It;.~YS~ 5... '
LJ LJ VERIFICATION OF QUANTITIES
~.
o 0 VERIFICATION OF HAT MAT TRAINING
LJ LJ EMERGENCY PROCEDURES ADEQUATE
. ~:::t~_.U:....
. P"~'''d' ~O \ --.. ..
. . ... .. ...'SSP .un ...
o 0 CONTAINERS PROPERLY LABELED
o O. FIRE PROTECTION
LJ 0 SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?:
LJ YES
J(No
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
._..._.__~~~$__. . ~ /'3 .
Inspector (Please Prinl)----' ..--. -.-...-. FirePrevention'1si~I';ishiti ofSiteP- ,...
Business Sile Respon
I
While - Environmental Services
Yellow - Station Copy
Pink . Business Copy
~
~
--
I
...... ~ . ~
MATERIAL SAFETY DATA SHEET
ACID CONCENTRATE FOR BICARBONATE DIALYSATE
Date Prepared: June 6,2001
GENERA!"INFORMA liON
Manufacturer: GAMBRO Renal Products
1845 Mason Avenue
Daytona Beach, Fl 32117-5102 USA
Telephone: 386-274-2811
Fax: 386-274-2833
Emergency Chemtrec: 800-424-9300
,"."."'S~GTIQN'1'.._. PRo'DUGTJOt\tIB'E'I~jTJf.JCXTI()N"
c..,
GAMBRO..Renal Products
Product Name: Acid Concentrate for Bicarbonate Dialysate
. , . . - .
, SI;CTION'2-QOMPQSI1"!QNANQINGR:ggJ$NT)NEQRMA TION:
" . _;,_,">""'_ ,.:i_"_ "_,__-.''': .,:_. __;,._...._.':...__:..,._ ,.n"",,"':'- ",.'..:.'_" :,' __"', ,,",; ",_"',,'; _-., '. ..< ".__.,._,_',_-__.,__".
Component Proportion CAS No. Hazardous
Sodium Chloride
Calcium Chloride
Potassium Chloride
Magnesium Chloride
Acetic Acid
Dextrose
Water
YES
NO
NO
NO
YES
NO
NO
Less than 25%
Less than 1 %
Less than 2%
Less than 1 %
Less than 1 %
Less than 10%
Remainder (solvent)
7647-14-5
10043-52-4
7447-40-7
7791-18-6
64-19-7
50-99-7
7732-18-5
sgCTION, 3:HAiAR[)~I[)ENTIFjcATlhN,,1:.:;,'\ ',' ".
. ... .'~'" ., , ~", .. .^ _, ~. .. _"" "_' '_' .. .". .';'J, ';-:-.
""- -.-;::\".......,:..
Emer~encv Overview
Caution! May be harmful if swallowed. Inhalation of vapors may cause irritation to respiratory tract.
Contact with skin may cause irritation to skin. Contact with eyes may result in irreversible damage.
Health
1 - Slight
OSHA SAFETY DESIGNATIONS
Flammability
o - None
Reactivity
o - None
For handling open containers, use of the following protective equipment is recommended:
Recommended Protective Equipment: Lab coat, safety goggles, gloves.
Recommended Storage Conditions: General storage, below 1100F (430C). Avoid freezing.
E18-05-A01B
Page I of 6
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave" CA 93301 (661) 326-3979
~
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
~.E..~.._.__ 0 ~~_._..___ 0 DELETE
o REVISE
200
I. FACILITY 1~IFORMATtON
. 'BuSiNESSNAME (Sameas FACfLfrf" NAMEor DaA. Doing Bus,ness As> .
., ____._._._.&~~.er~
~-ru.c~
CHEMICAL LOCATION
: 7N<;,pG-- ~ ~~--'V'"( ,'2o:JCJ~
:FACILifYiCi#j-~-"T---i-I:"~i 'j-" . . ...... liiM-p'#(opiionaiju .-
. : lJ~__LLL-j_..j..__" :. . __......._:...".._.__._.... H..'._
II. CHEMICAL 1,'IlFORMATION
.~------------_. ..-...--..-.....----.',.
CHEMICAL NAME r,' 11 __....,
c,. Ac.~Q_....... \. fn - '--_
~ () (~-LYS'0
Co ...vq::-'V~-e
COMMON NAME
C~SII
-FiRECODE"i-illi'RDCLASSES (C,impiete'j(req'uesled by I.oc;.i /i,e"chiei)
,
--fYpf:-.---..---------[j ;~~~~
.~. MI~~~'~~
o w WA~-:--:'
R .\~}IOAr.TIVE
PHYSICAL STATE
LARGEST CONTAINER
Q<.uaUID
OgGAS
o s SOLID
214
: FED HAZARD CATEGORIES
\(Check all that apply)
o 3 PR"S3 jRE :-:ELE"SE
g;; A;U"E HEALTH
01 FIRE
o 2 REACTIVE
ANNUAL WASTE
AMOUNT
:<18 AVERAGE
DAILY AMOUNT
217 ,\'''~IMl'M
DAILY AMOUNT
1~
UNITS' 2(ga GAL 0 d CU FT D Ib LBS
. If EHS, amount must be in Ibs.
[] In TONS
STORAGE CONTAINER'
(Check a/l that apply)
~ABOVEGROUND TANK
Db UNDERGROUND TANK
DC TANK INSIDE BUILDING
o d STEEL DRUM
De PLASTIC/NONMETALLIC DRUM
Of CAN
o g CARBOY
o h SILO
o i FIBER DRUM
Cj BAG
D k BOX
o I CYLINDER
, STORAGE PRESSURE
~ AMBIENT
D ba BELOW AMBIENT
D b) BELOW AMBIENT
EHS
l' :"
CAS #
D aa ABOVE AMBIENT
STORAGE TEMPERATURE
t8l:a AMBIENT
o aa ABOVE AMBIENT
%WT .
"':),?;~},,:-
_ 'H.J_..
HAZARDOUS COMPONENT
226 i
I So D I 01""1
.-,---.. -. .--. -..."1---...'-.. ..,
2-5""
2: (0 230 D~Se
l....n.._.!__.___ __._."..n _.._____.L ..____u..
I I
: 3 234 i
I I 2 I fO~ss(c.Jl'V1 c..t-(t..on.., oE
[4~~L~.~_.~...~t-._~:-~~~.L~6_~~i ~ ACt 0
I 5 i . 242 I
r------.-...--..J-.-...-:-~_.-.. . ....,. ....'..'..,'.,..
I '
I .
r'PRiNT'NAME'njT[En~fF ~tftHORIZEi)"cOMPANY REPRESENTATIVE ..
I..,., __... ...n'..__..........._............
c (-f~I{)e
- - . ----.
III. SIGNATURE
SiGNA TURE .
~
UPCF (7/99)
(one form per malerial per building or area)
Page or
.".----....-------- ---..~------..---l
...---..-.--...--..--.-.--3
203
2~1 CHEr.llCAL LOCATION
CONFIDENTIAL (EPCRA)
GRID # (option;.!)- .. , ..--.-------.---204.
o Yes 0 No 202
-'i6S'--TRADE SECRET - 0 Y;; D ~~-206 ..
If Subject 10 EPCRA, refer to instructions
207
EHS'
o Yes D No 208
209 'J( EHS is'Yes,' all amounts below must be in Ibs.
210
DYes DNo
"---;~2" . CURiES
"213
300
215
D 5 CHRONIC HEALTH
216
('C9Ud
219 STATE WASTE CODE
220
221
DAYS ON SITE
222
,
." -..------------
D m GLASS BOTTLE
o n PLASTIC BOTTLE
D 0 TOTE BIN
o 0 TANK WAGON
o q RAIL CAR
o r OTHER
223
224
o c CRYOGENIC
225
227
DYes D No 228, ,.._2~.'3..]::_~4 _ ~___~2:'"
231 : DYes 0 No 232....._._. ~~...~_~y...=.?_._~..~...
o Yes D No 236 n__' .74 _~7...~.19 ___z._':"~7
DYes 0 No 240__....__~_~.~J5..='1_.._..__2~~..
235
239
243
245
Dyes 0 No 244
,... .....--.-.------.-----'-.....,..,.------.1
!
._.n___....__...._ DATE "-'246'
._..._._.......4L.~!cd.r __._ .
S:\CUPAFORMSIOES2731,TV4.wpd
DIPLOMATE AMSRICAN BOARD OF INTSRNAL MSDICINE
DIPLOMAT~SUB8PSCIAtTV OF NEPHROLOQY
fU.R. VARANASI, M.D., EA.C..P.
'NEPHROLOGY' HYPERTENSION
INTERNAL MEDICINE
KERN NEPHROLOGY
MEDICAL GROUP
ARVIND S. SHAH. M.D., INO,
U.R, VARANASI, M.D.. INC.
ATUL H. SURI, M.O.. INC,
820 34TH. STREET
BAKERSFIElD, CALIF. 83301
(661) 324-4721
FAX (861) 324.2326
EMAIL.KNMOOAOL.COM
G'.. -4 ~