HomeMy WebLinkAboutBUSINESS PLAN 3/19/2007
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DEDICATED DENTAL. CALIFORNIA CTRj
3400 WIBLE ROAD
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Manager :
Location:
City
DENTAL-~RNIA
~~= GON~Xi;O
3400 WIBLE RD
BAKERSFIELD
CTR ===================== SiteID: 015-021-002278 +
+ DEDICATED
LOrEl~
BusPhone:
Map : 123
Grid: 12C
(661) 835-8672
CommHaz : Minimal
FacUnits: 1 AOV:
CommCode: BFD STA 07 SIC Code:8021
EPA Numb: DunnBrad:
+==============================================================================+
+=======================================+======================================+
Emergencyvcant~ct / Title Emergency Contact / Title
LORRAIN-E \fD;{UUJ/ / MANAGER /
Business P~ne: (661) 835-8672x Business Phone: () x
24-Hour Phone : (661) 332-8055x 24-Hour Phone : () x
Pager Phone : () x Pager Phone : () X
+---------------------------------------+--------------------------------------+
I Hazmat Hazards: React I
+------------------------------------------------------------------------------+
Contact : MQnI~UE -:I:'V\e..'Z-- Phone: (661) 835-8672x
MailAddr: 3400 WIBLE RD State: CA
City : BAKERSFIELD Zip : 93309
+-------------------------------------------------------------~----------------+
Owner INTERDENT INC Phone: () x
Address: 222 N SEPULVEDABLVD.}40 State: CA
City : EL SEGUNDO Zip : 90245
+------------------------------------------------------------------------------+
Period to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif1d: RSs: No
ParcelNo:
+--------,----------------------------------------------------------------------+
Emergency Directives:
PROG H - HAZ WASTE GEN
~~o\'t
ENT'D MA~ 1 9 2007'
+==============================================================================+
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:.!-. - ---
~ ~
+ DEDICATED DENTAL-CALIFORNIA CTR ===================== SiteID: 015-021-002278 +
+= Hazmat Inventory ========================================= By Facility Unit +
+== MCP+DailyMax Order ============================= Mobile Containers at Site +
+--------------------------------+-------+-----------+-----+----------+----+---+
I Hazmat Common Name... ISpecHazlEPA Hazards I Frm I DailyMax IUnit/MCpl
+-------------------~------------+-------+-----------+-----+----------+----+---+
WASTE FIXER R L 5.00 GAL Min
+==============================================================================+
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+ DEDICAtED DENTAL-CALIFORNIA CTR ===================== SiteID: 015-021-002278 +
+= Inventory Item 0001 ============== Facility Unit: Mobile Containers at Site +
+== COMM0N NAME / CHEMICAL NAME ==============================+================+
WASTE fIXER I Days On Site I
I 365
Loca~ion within this Facility Unit Map: Grid: +----------------+
i I CAS # I
+=============================================================+================+
+= STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+
I Liquid I Waste I Ambient I Ambient I PLASTIC CONTAINER I
+=======1=+==========+===============+===============+=========================+
+==========================+ AMOUNTS AT THIS LOCATION =========================+
I Lar~est Container I Daily Maximum I Daily Average I
I 5.00 GAL 5.00 GAL 5.00 GAL
+--------------------------+-------------------------+-------------------------+
+:::::::~::::::::::::::-HAZARDOUS-COMPONENTS-::::::::=:::::~:::~:::::::::::::::+
I %Wt. I I RS I CAS # I
Silver No 7440224
+=======t==================================================+===+===============+
+=======~===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+
I TSecretI RS\BioHazl Radioactive/Amo~t I EPA Hazards I NFPA I USDOT# I M~P I
No No No No/ Cur1es R / / / M1n
+=======t===+======+====================+=============+=========+========+=====+
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+
SiteID: 015-021-002278
+================================================================= Fast Format
Notif./Evacuation/Medical ==================================== Overall Site +
=======================================================+
DEDICATED DENTAL-CALIFORNIA
CTR
---------------------
---------------------
+
+
+=
+--
--
+==============================================================================+
+--- Employee Notl'f /Evacua.tl'on -----------------------------------------------+
--- . -----------------------------------------------
+==============================================================================+
+---- Publl'C Notl'f /Evacuat;on ------------------------------------------------+
---- . ~ ------------------------------------------------
+===================~==========================================================+
+===== Emergency Medical Plan =================================================+
+==============================================================================+
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+ DEDICATED DENTAL-CALIFORNIA CTR ===================== SiteID: 015-021-002278 +
+================================================================= Fast Format +
+= Mitigation/Prevent/Abatemt =================================== Overall Site +
+== Release Prevention ========================================================+
+==============================================================================+
+=== Release Containment ======================================================+
+==============================================================================+
+==== Clean Up ================================================================+
+==============================================================================+
+===== Other Resource Activation ==============================================+
+==============================================================================+
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+ DEDICATED DENTAL-CALIFORNIA CTR ===================== SiteID: 015-021-002278 +
+================================================================= Fast Format +
+= Site Emergency Factors ======================================= Overall Site +
+== Special Hazards ===========================================================+
+==============================================================================+
+=== Utility Shut-Offs ========================================================+
+==============================================================================+
+---- Fl're protec /Aval'l Water -----------------------------------------------+
---- .. -----------------------------------------------
+==============================================================================+
+===== Building Occupancy Level ===============================================+
+==============================================================================+
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+ DEDICATED DENTAL-CALIFORNIA CTR ===================== SiteID: 015-021-002278 +
+================================================================= Fast Format +
+= Training ===================================================== Overall Site +
+== Employee Training =========================================================+
+==============================================================================+
+=== Page 2 ===================================================================+
+==============================================================================+
+==== Held for Future Use =====================================================+
+==============================================================================+
+===== Held for Future Use ====================================================+
+==============================================================================+
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+ DEDICATED DENTAL-CALIFORNIA CTR ===================== SiteID: 015-021-002278 +
+= Full Format =================== Type+CategorY+Sub-Category+Date2(~S~) Or~er +
+============================================================ One Unlfled Llst +
+================================ INSPECTIONS =================================+
IBUSINESS PLAN PROGRAM ROUTINE INSPECTION I
+------------------------------------------------------------------------------+
I Reference Dates Summary Description I
+------------------------------------------------------------------------------+
WINES 11/13/2001 OKAY
NEW PERMIT NEEDED
+------------------------------------------------------------------------------+
IHAZARDOUS WASTE GENERATOR ROUTINE INSPECTION I
+------------------------------------------------------------------------------+
I Reference Dates Summary Description I
+------------------------------------------------------------------------------+
WINES 11/13/2001 OKAY
+==============================================================================+
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05/15/2006
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CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
Section 4:
Hazardous Waste Generator Program
INSPECTION DA TE.3 /J J / f) 7
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FACILITY NAME 1) 6..1:) \ C P\'T(.n 'De:. #,.)'f~L..
EP AID #
o Routine
m Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION
C V
--~
COMMENTS
Hazardous waste detennination has been made
EP A ID Number
~;>C:6~P-t
Authorized for waste treatment and/or storage
Reported release, fire, or explosion within 15 days of occurrence ----:-- f.o
Established or maintains a contingency plan and training - ~
---I--.... ,
Hazardous waste accumulation time frames I -- tIJ-E ~D ..$'""fq r+ TJ-r+, j
Containers in good condition and not leaking ..1
Containers are compatible with the hazardous waste
-f.i
Containers are kept closed when not in use
Weekly inspection of storage area
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---......
Ignitable/reactive waste located at least 50 feet from property line
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Secondary containment provided
Conducts daily inspection of tanks
Used oil not contaminated with other hazardous waste
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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
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Retains manifests for 3 years
Retains hazardous waste analysis for 3 years
Retains copies of used oil receipts for 3 years
Detennines if waste is restricted from land disposal
C-Compliance C t1?'t~o~
Inspector: p- 'I
Office of Environmental Services (661) 326-3979
White - Env. Sves.
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Pink _ Business Copy BUS~SS Site ):(espon~ible Party
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UNIFIED PROGRAM INSPECTtON CHECKLIST;; "..
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SECTION 1: Business Plan and Inventory Program -
BAKERSFIELD FIRE DEPI'
Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield. CA 93301
Tel.: (661) 326-3979
Fax: (661) 872-2171
FACILITY NAME
D GJ:n C 4\'1 ~D
ADDRESS
NSPECTION TIME
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UE.~f\L.
cj) \ ~LE. fA.
o OF EMPLOYEES
FACILITY CONTACT
Section 1: Business Plan and Inventory Program
o ROUTINE )B COMBINED 0 JOINT AGENCY- 0 MUl TI-AGENCy---ef" COMPLAINT
ORE-INSPECTION
C V (c=comp iance)
V=Violation
OPERATION
COMMENTS
o ApPROPRIATE PERMIT ON HAND
o Business PlAN CONTACT INFORMATION ACCURATE
o VISIBLE ADDRESS
o CORRECT OCCUPANCY
o VERIFICATION OF INVENTORY MATERIALS
o VERIFICATION OF QUANTITIES
o VERIFICATION OF LOCATION
",l1ff ! s
o PROPER SEGREGATION OF MATERIAL
, "
o VERIFICATION OF MSDS AVAILABILITY
o VERIFICATION OF HAl MAT TRAINING
0)8 VERIFICATION OF ABATEMENT SUPPLIES AND
PROCEDURES
Scr\-.t CO"'+c...~ ~ Q.~ ()."-~
0 EMERGENCY PROCEDURES ADEQUATE
0 CONT AINEAS PROPERLY lABELED = "ll..... b.u~ ~~ ~~rl t-~b~)
0 HOUSEKEEPING
0 FIRE PROTECTION
0 SITE DIAGRAM ADEQUATE & ON HAND
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ANY HAZARDOUS WASTE ON SITE?~ES
EXPLAIN: ~ Ct ~.+ ~ - f' k@ r
o NO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (881) 328-397
L-?~IL~":J ~-~ .
Inspector (Please Print) Fire Prevention 111 In IS' of SitelStation ,
While - Prevention SelVices
Yellow. Slelion Copy
Pink - Business Copy
FD2049 (Rev. 02105)