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Home My WebLink About5625 GOSFORD ROAD _HMBP 11.4.10UNIFIED PROGRAM INSPECTION CHECKLIST) SECTION 1: Business Plan and Inventory Program e B _ _ Ii DR5FIIli1 _ FIRE10ARTM T BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME 5910 S Glv STa2Tlf0>v INSPECTION DATE r 41 a INSPECTION TIME 1Jn a.-- ADDRESS 2!_ 6o APPROPRIATE PERMIT ON HAND L c / i N NEW F2CiJlj jjF,/> VE G(s /sSu Ott NO. OF EMPLOYEES FACILITY CONTACT CCR: 2729.1) 93313 BUSINESS ID NUMBER a"- CORRECT OCCUPANCY Consent to I pact Name /Tit L u Z Section 1: Business Plan and Inventory Program ROUTINE COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION C V C= Compliance) OPERATION V= Violation COMMENTS APPROPRIATE PERMIT ON HAND BMC: 15.65.080) NEW F2CiJlj jjF,/> VE G(s /sSu Business PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1) VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) CORRECT OCCUPANCY CBC:401) VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3) VERIFICATION OF QUANTITIES CCR: 2729.4) VERIFICATION OF LOCATION CCR: 2729.2) PROPER SEGREGATION OF MATERIAL CFC: 2704.1) K VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) 110-be-2 VERIFICATION OF HAZ MAT TRAINING CCR: 2732) VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) EMERGENCY PROCEDURES ADEQUATE CCR: 2731) CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5) p270 q//&//O HOUSEKEEPING CFC: 304.1) FIRE PROTECTION CFC: 903 & 906) SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) ANY HAZARDOUS WASTE ON SITE? YES NO Sipnature of Receipt Explain: 2/ Cp,vTP.'N it G USE S b2v j- POST INSPECTION INSTRUCTIONS: o Correct the violation(s) noted above by Within 5 days of correcting all of the violations, sign and return a copy of this page to: Bakersfield fire Dept., Prevention Services, 2101 1 -1 Street, California 93301 LNSQ Tcr. 13y: C-;e1U1E MED /AvJ White —Business Copy Yellow — Business Copy to be Sent in alter return to Compliance Sid ature 0161 a I violations have been corrected as noted) Date Pink — Prevention Services Copy FD2155 (Rev 61/10) KERN BUSINESS FORMS – (661)325- 5818– #6013 r` r —V e UNIFIED PROGRAM INSPECTION CHECKLISTI E R s F e ° 1 FIRE SECTION I : Business Plan and Inventory Program t BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME Section 1: Business Plan and Inventory Program INSPECTION DATE INSPECTION TIME ADDRESS 7L L PHONE ` sGS NO OF EL /LOYEES FACILITY CONTACT COMMENTS 3g3/_3 El BUSINESS ID NUMBER New Fy e i 1" - f3 FD A Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) Consent to In pect Name /Titl 1z uZ CAS S ri c7 i C- (v/v G"'%Q._tJ Q h2 NUJT INSPLC'FIUN INS I RUC7'IVNJ: Correct the violation(s) noted above by Within 5 days of correcting all of the violations, sign and return a copy of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 While —Business Copy Yellow — Business"Copy tc be Sent in after return to Compliance Signature (that all violations have been corrected as noted) Date pink — prevention Services Copy VD2155 (Rev 6010)- Section 1: Business Plan and Inventory Program ROUTINE COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION C V C= Compliance OPERATION V= Violation COMMENTS El APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) New Fy e i 1" - f3 FD A Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) CORRECT OCCUPANCY (CBC: 401) VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) VERIFICATION OF QUANTITIES (CCR: 2729.4) VERIFICATION OF LOCATION (CCR: 2729.2) PROPER SEGREGATION OF MATERIAL (CFC: 2704.1) I;( VERIFICATIONVERIFICATION OF MSDS AVAILABILITY (CCR: 2729.2(3)(b)) iudj pN Sr`'f 1 f //17 // P.. VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5) ST--P 7- p2TC 9 11p I HOUSEKEEPING (CFC: 304.1) FIRE PROTECTION (CFC: 903 & 906) SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) ANY HAZARDOUS WASTE ON SITE? KYES NO Signature of Receipt Explain: NUJT INSPLC'FIUN INS I RUC7'IVNJ: Correct the violation(s) noted above by Within 5 days of correcting all of the violations, sign and return a copy of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 While —Business Copy Yellow — Business"Copy tc be Sent in after return to Compliance Signature (that all violations have been corrected as noted) Date pink — prevention Services Copy VD2155 (Rev 6010)- 5 aptJS C 1v " C1 ,1rA __%7-_,,77;:W FACILITY NAME: o S S a,i2 l C44 9 3313 Section 2: Underground Storage Tanks Program BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 of 1 INSPECTION DATE: 111g1to Routine Combined Joint Agency Multi- Agency Complaint Re- Inspection Type of Tank P—W Number of Tanks 3 Type of Monitoring Type of Piping L>W F OPERATION C V COMMENTS Proper tank data on file Proper owner / operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current X Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes X No Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding /labeling Is tank used to dispense MVF ?) If yes, does tank have overfill / overspill protection? C = Compliance V = Violation Y = Yes N = No Inspector: i21Uf z1 r _Va_ Questions regarding this inspection? Please call us at (661) 326 -3979 White — Prevention Services Business Site Responsible Party Pink - Business Copy KBF -7335 FD 2156 (Rev. 09/05) /