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HomeMy WebLinkAboutHazmat Business Plan 10/07 .+ TINER DENTAL CORP =================================== SiteID: 015-021-002848 + Manager : Ameet Chopra DDS Location: 820 34TH ST 201 City BAKERSFIELD BusPhone: Map : 103 Grid: 19B (661) 327-7878 -\ CommHaz : Low FacUnits: 1 AOV: CommCode: BFD STA 04 SIC Code: EPA Numb: DunnBrad: +==============================================================================+ +=======================================+===================================~==+ Emergency Contact / Ti tIe ~ Emergency Contact / Ti tIe 'f Ameet Chopra DDS / SURGEON ~M(c4-(lh AKIM ALEXANDER / BACK OFFICE MGR Business Phone: (661) 327-7878x Business Phone: (661) 327-7878x 24-Hour Phone : (916) 798-4915x 24-Hour Phone : (661) 342-1894x Pager Phone () - x Pager Phone : () x +---------------------------------------+--------------------------------------+ I Hazmat Hazards: Fire Press React ImmHlth DelHlth I +------------------------------------------------------------------------------+ Contact : TRUDY WHITE Phone: (661) 327-7878x MailAddr: 5708 PIRRONE RD State: CA City : SALIDA Zip : 95368 +------------------------------------------------------------------------------+ Owner MR DAVIS C/O MANCO ABBOTT Phone: (661) 334-4800x Address : 5000 CALIFORNIA AVE State: CA City : BAKERSFIELD Zip : 93309 +------------------------------------------------------------------------------+ Period to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No parcelNo: +------------------------------------------------------------------------------+ Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN Based on ""'v inquiry of those injividlJa~s ,--,.."',,,;::,;... for v.)tait ,i, '1:1 ii ItI illiofllll:dion, I certilY unde: penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true. accurate, and complete. . JD 3)'01- Date +========================================================~-==:==================+ ~ -1- ~~- " 10/26/2007 ~ ~ ~ + TINER DENTAL CORP =================================== SiteID: 015-021-002848 + += Hazmat Inventory ========================================= By Facility Unit + +== MCP+DailyMax Order ============================== Fixed Containers at Site + +--------------------------------+-------+-----------+-----+----------+----+---+ I Hazmat Common Name... ISpecHaz/EPA Hazards I Frm I DailyMax IUnitlMcpl +--------------------------------+-------+-----------+-----+----------+----+---+ OXYGEN F IH DH G 843.00 FT3 Low NITROGEN F P IH G 510.00 FT3 Min WASTE FIXER R L 4.00 GAL Min +==============================================================================+ -2- 10/26/2007 .+ TINER DENTAL CORP =================================== SiteID: 015-021-002848 + += Inventory Item 0003 =============== Facility Unit: Fixed Containers at Site + +== COMMON NAME / CHEMICAL NAME ==============================+================+ OXYGEN I Days On Site I 365 Location within this Facility Unit Map: Grid: +------------____+ I CAS # I 7782-44-7 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Gas I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER I +=========+==========+===============+===============+=========================+ +==========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I 843.00 FT3 843.00 FT3 422.00 FT3 +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I I RSI CAS # I 100.00 Oxygen, Compressed No 7782447 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ /Tsecret/ RSI BioHazI Radioactive/Amo~t I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curles F IH DH / / / Low +=======+===+======+====================+=============+=========+========+=====+ +========================== MISC. LOCAL AGENCY DATA ===========================+ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Definel0: +- Ag.Definell -------------------------------------___________________________+ +==============================================================================+ -3- 10/26/2007 + TINER DENTAL CORP =================================== SiteID: 015-021-002848 + += Inventory Item 0001 =============== Facility Unit: Fixed Containers at Site + +== COMMON NAME / CHEMICAL NAME ==============================+================+ NITROGEN I Days On Site I 365 Location within this Facility Unit Map: Grid: +----------------+ I CAS # I 7727-37-9 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Gas I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER I +=========+==========+===============+===============+=========================+ +==========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I 510.00 FT3 510.00 FT3 255.00 FT3 +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I I RSI CAS # I 100.00 Nitrogen No 7727379 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ I TSecretI RS/BioHaz/ Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curies F P IH / / / Min +=======+===+======+====================+=============+=========+========+=====+ +========================== MISC. LOCAL AGENCY DATA ===========================+ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined7: Ag.Defined5: Ag.Defined6: Ag.Defined8: Ag.Defined9: Ag.Definel0: +- Ag.Definell -------------------------------------------_____________________+ +==============================================================================+ -4- 10/26/2007 + TINER DENTAL CORP =================================== SiteID: 015-021-002848 + += Inventory Item 0004 =============== Facility Unit: Fixed Containers at Site + +== COMMON NAME / CHEMICAL NAME ==============================+================+ WASTE FIXER I Days On Site I 365 Location within this Facility Unit Map: Grid: +----------------+ I CAS# I +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Liquid I Waste I Ambient I Ambient I PLASTIC CONTAINER I +=========+==========+===============+===============+=========================+ +==========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I 4.00 GAL 4.00 GAL 4.00 GAL +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I I RSI CAS # I Silver No 7440224 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ /Tsecret/ RSIBioHazl Radioactive/Amo~t I EPA Hazards I NFPA I USDOT# I M~P I No No No No/ Curles R / / / Mln +=======+===+======+====================+=============+=========+========+=====+ +========================== MISC. LOCAL AGENCY DATA ===========================+ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: +- Ag.Definell ----------------------------------------------------------------+ +==============================================================================+ -5- 10/26/2007 + TINER DENTAL CORP =================================== SiteID: 015-021-002848 + += Inventory Item 0004 =============== Facility Unit: Fixed Containers at Site + +==================+=========+====== WASTE DATA ===========+===================+ I TreatedN~n Site I CA Code I US Code I GAL Generated/Mo. I GAL Generated/Yr. I +------------------+---------++--------+-------------------+-------------------+ I Treatment UnitID: I Unit Type: I +-----------------------------+------------------------------------------------+ Agency-Defined Text Label +==============================================================================+ -6- 10/26/2007 + TINER DENTAL CORP =================================== SiteID: 015-021-002848 + +================================================================= Fast Format + +- Notl'f /Evacuatl'on/Medl'cal ------------------------------------ Overall Sl'te + -. ------------------------------------ +== Agency Notification =========================================== 05/09/2007 + CALL 911. NON-EMERGENCY CALL 326-3979. +==============================================================================+ +--- Employee Notl'f /Evacuatl'on ----------------------------------- 05/09/2007 + --- . ----------------------------------- VERBAL NOTIFICATION AND CALL 911. +==============================================================================+ Pub I , t'f /E ' 08/11/2003 +==== lC No 1. vacuatlon ==================================== + LOCAL NURSE WOULD CALL ALL CLIENTS +==============================================================================+ +===== Emergency Medical Plan ===================================== 05/09/2007 + MEMORIAL HOSPITAL, 420 34TH ST, 327-1792 +==============================================================================+ -7- 10/26/2007 + TINER DENTAL CORP =================================== SiteID: 015-021-002848 + +================================================================= Fast Format + += Mitigation/Prevent/Abatemt =================================== Overall Site + +== Release Prevention ============================================ 08/11/2003 + GASES ARE CHAINED AND STORED WITH PROPER VALVES AND FITTINGS +==============================================================================+ +--- Release Contal'nment ------------------------------------------ 08/11/2003 + --- ------------------------------------------ SHARPS CONTAINERS FOR NEEDLES AND TEETH +==============================================================================+ +---- Clean Up ---------------------------------------------------- 08/11/2003 + ---- ---------------------------------------------------- ALL CONTAINERS ARE PICKED UP BY SECURITY ENVIRONMENTAL +==============================================================================+ +===== Other Resource Activation ==============================================+ I I +==============================================================================+ -8- 10/26/2007 .+ TINER DENTAL CORP =================================== SiteID: 015-021-002848 + +================================================================= Fast Format + += Site Emergency Factors ======================================= Overall Site + +== Special Hazards ===========================================================+ I I +==============================================================================+ +=== Utility Shut-Offs ============================================ 05/30/2007 + DOOR N END OF BLDG E OF ELEVATOR +=============================:================================================+ , / 'I / / +==== Flre Protec. Aval . Water =================================== 02 02 2007 + PRIVATE FIRE PROTECTION. THREE FIRE EXTINGUISHERS: ONE IN EMPLOYEE LUNCH ROOM, AND ONE BY X-RAY ROOM. ONE IN FRONT OFFICE, +==============================================================================+ +_____ BU1'ldl'ng Occupancy Level ----------------------------------- 03/03/2006 + ----- ----------------------------------- 15 EMPLOYEES +==============================================================================+ -9- 10/26/2007