HomeMy WebLinkAbout4050 GOSFORD ROAD_HMBP 6.4.12UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
FACILITY NAME
BAKERSFIELD .FIRE DEPT..
INSPECTION TIME
Prevention Services
e r e_esFIE _D -.
FIRE 2101 H Street
D AMTN T Bakersfield, CA 93301
Tel.: 661) 326 -3979
9.33 - yoo2-
Fax: (661) 852 -2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
COMMENTS
In
ADDRESS PHONE NO. NO OF EMPLOYEES
BUSINESS PLAN CONTACT INFORMATION ACCURATE
9.33 - yoo2-
tJrl f '-n K fO
FACILITY CONTACT BUSINESS ID NUMBER
CFC:505.1, BMC: 15.52.020)
5 - - OD3 / 2
Consent to Inspect Name /Title
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: 1.65.080)
BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
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VISIBLE ADDRESS CFC:505.1, BMC: 15.52.020) elAA OV ( p'., -j e . ,
CORRECT OCCUPANCY CBC: 401)
VERIFICATION OF INVENTORY. MATERIALS CCR: 2729.3)
VERIFICATION OF QUANTITIES CCR: 2729.4)
VERIFICATION OF LOCATION CCR: 2729.2)
13! PROPER SEGREGATION OF MATERIAL CCR: 2704.1)
VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(8))
VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES CCR: 2731))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
CONTAINERS PROPERLY LABELED CCR: 66262.34(F),.CFC 2703.5)
HOUSEKEEPING CFC:304.1)
FIRE PROTECTION CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) J-" i (00W(ce
D (11 J5 L) 4
alnd
ANY HAZARDOUS WASTE ON SITE? YES NO Si nature ofReceipt
Explain:
POST INSI'LUTION INJ'1'RUC:I IVNS:
Refer to the back of this inspection report for regulatory citations and corrective actions
Correct the violation(s) noted above by
Within 5 days ofcorrecting all of the violations, sign and return a copy of this page to:
Bakersfiel Rk _I'gtlt tt Services, 2101 H Street, California 93301
332226-
1+Y3'
3111l 58WWUU
IIY
White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance
Signature (that all violations have been corrected as noted)
Date
Pink Prevention Services Copy 17D2155 (Rev 12/11 )
o - n
11 KERN PRINT SERVICES - (661) 325 -5818 - KPS -2215
UNIFIED PROGRAM INSPECTION CHECKLIST B_ '' "se ="iF/RE /
SECTION 1: Business Plan and Inventory Program
63/46 2
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
zFACILITYNAME , INSPECTION DATE INSPECTION TIME
4
V= Violation
Iti
ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
Consent to Inspect Name /Title
Section 1: Business Plan and Inventory Program
ROUTINE . COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION
C v c C= Cornpliance) OPERATION COMMENTS
V= Violation
Iti APPROPRIATE PERMIT ON HAND BMC: 1.65.080)
BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
Lrl VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020)
I
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 CCR: 2704.1)
VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(6))
VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES CCR: 2731))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
CONTAINERS PROPERLY LABELED CCR: 66262.34(F), CFC 2703.5)
s
E1 HOUSEKEEPING CFC: 304.1)
FIRE PROTECTION CFC: 903 & 906)
y SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? YES NO Silzmature of Receipt
Explain:
POST INSPECTION INSTRUCTIONS:
Refer to the back of this inspection report for regulatory citations and corrective actions
Correct the violation(s) noted above by
Within 5 days ol'correcting all ofthe violations, sign and return a copy of this page lo:
BakersfieldW"O to rvices, 2101 H Street, California 93301
White — Rosiness Copy Yellow— Business Copy to be Sent in after return to Compliance
Signature (that all violations have been corrected as noted)
Date
Pink Prevention Services Copy I'D2155(Rev 12/11)
BAKERSFIELD FIRE DEPT.
INSPECTIONS
BUSINESS PLAN &
INVENTORY PROGRAM
UNIFIED PROGRAM INSPECTION CHECKLIST
FACILITY NAME: a _ gd
709
Section 2: Underground Storage Tank Program
rLE Prevention Services
B n a n 1501 Truxtun Avenue, 1st Floor
P/R/ Bakersfield, CA 93301
O A-
V
T Tel.: (661) 326 -3979
Proper owner / operator data on file
Fax: (661) 852 -2171
Page I of I
Routine Combined
Type of Tank _
Type of Monitoring _
Joint Agency Multi- Agency Complaint
Number of Tanks
Type of Piping
INSPECTION DATE:
Re- Inspection
OPERATION C V COMMENTS
Proper tank data on file
Proper owner / operator data on file 2O" WS C,
Ac v
Permit fees current
Certification of Financial Responsibility
Monitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations y
Has there been an unauthorized release? Yes No
Section 3: Aboveground Storage Tank 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 ?)
o It yes, does tank have overfill / overspIII protection?
F.
k.
C = Compliance V = Violation Y = Yes N = No
6 -36 ,0
Questions regarding this inspection? Please call us at (661) 326 -3979
B Responsible Party -
White - Prevention Services Pink - Business Copy
FD 2156 (Rev. 03 /08)
GS