HomeMy WebLinkAbout1125 coffee rd fmc inspection reportUnderground Storage Tank Program
DW Inspection Repo
Permission to Inspect:
BAKERSFIELD FIRE DEPARTMENT
Prevention Services, Division
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979
Fax.- 661-852-2171
Business Name: CHEVRON 203576-15-021-104204-A/iewiC G(k-(-
Date:12/8/2015
Address Name: 1125 COFFEE RD-CAR000124990
Inspector Name: Shane Gardner #8248557
Inspection Type: Routine
Report :Final
NVO = No Violation.. Observed OUT= Out of Compliance NA =Not Applicable UD = Undetermined
COS = Corrected On Site RPT = Repeat Violation
Violation
Program Requirement
'81-'
0
SOC
Comments
No
M
<t
0
0
a.
Z
0
z
:)
()
W
0>
Pile Review ci(o D-4>-,F C-47{;
Facility Tank Information
2030021
Facility has a valid Permit
Tank 1-12000-DW-PRM
to Operate from the
Tank 2-12000-DW-MID
CUPA - 23 CCR 16 2712(1);
❑
None
Tank 3-12000-DW-REG
HSC 6.7 25284
Tank 4-
2010010
UST Operating Permit
Application for Facility
information and Tank
information
❑
❑
❑
❑
f-1
None
submitted/maintained - 23
CCR 16 2711; HSC 6.7
25286(a)
2010001
Current BOE number
submitted to the CUPA
37
❑
❑
❑
❑
❑
None
and/or CERS - HSC 6.7
25286(c)
2030011
UST compliance
statement and/or
Designated Operator
❑
❑
❑
❑
Fj
None
current certification
submitted - 23 CCR 16
2715(a), 2715(b)
2030046
A complete and accurate
response plan has been
submitted, approved and
JZ'
E]
None
maintained - 23 CCR 16
2632, 2634(e), 2641(h),
2712(i)
2030041
A complete and accurate
plot plan has been
submitted, approved and
Minor
maintained - 23 CCR 16
2632(d)(1 C), 2711(a)(8
2010006
Owner/Operator has not
made false statements or
representation on any
❑
❑
❑
None
required document - HSC
6.725299
2010003
Owner/Operator has a
DO and/or informed the
CUPA of any change (s)
❑
❑
F-1
❑
Ej
None
within 30 days - 23 CCR
16 2715(a)
Violation
Program Requirement
o
SOC
Comments
No
0
>
In
W
0
0.
010
z
0
z
W
Testing
2030002
Owner/Operator has
96 days past due
tested and certified leak
❑
None
detection equipment
annually - 23 CCR 16 2638
2030048
Secondary containment
testing conducted every
36 months in accordance
None
with requirements - 23
CCR 16 2637
2030055
Spill buckets have been
96 days late
tested annually as
None
required - HSC 6.7 25284.2
2010009
Secondary containment
test results submitted to
the CUPA within 30 days
None
after the test - 23 CCR 16
2637(e)
2030064
CUPA was poperly
notified within the
prescribed number of
❑
❑
❑
None
hours prior to testing - 23
CCR 16 26370, 2638(e),
2643(g), 2644.1(a)(4)
Install/Repair
2060009
Permits obtained to
install, replace, repair, or
0
REJ
❑
❑
❑
None
modify part of the UST
system - 23 CCR 16 2712
--------
LIST System Observation
General Monitoring
2030003
Leak detection system
maintains continuous
RD
monitoring that activates
None
❑
an audible and visual
Yes
alarm - 23 CCR 16 2632,
2634, 2636, 2666
2030016
The annular space of the
tank, piping and sumps
are continuously
RD
monitored and activates
None
❑
the alarm - 23 CCR 16
Yes
2631(8), 2632(c)(2)(A)&(8),
2633(c), 2636(o
2030017
Product piping outside the
UDC is fail-safe and shuts
down the pump or
S
❑
❑
❑
❑
❑
None
restricts flow - 23 CCR 16
2636(1) (5
2030018
Turbine sump monitor
activates an audible and
RD
visual alarm or stops the
None
❑
flow of at the dispenser
Yes
23 CCR 16 26360(1)
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
,o
SOC
Comments
No
�o
z
o
z v
o>
2030019
Monitoring system in the
UDCs activates an
audible and visual alarm
®
❑
❑
❑
❑
❑
None
or stops the flow at the
UDC -23 CCR 16
2636 fl(1)
2030043
Leak detection equipment
properly programmed or
RD
properly operated - 23
®
❑
❑
❑
❑
❑
None
❑
CCR 16 2632, 2634, 2636,
Yes
2666
2060005
System constructed with
a monitoring system
capable of detecting entry
®
❑
❑
❑
❑
❑
None
into secondary
containment - HSC 6.7
25291(b)
2060014
Correct leak detection
equipment installed for
RD
the type of system
®
❑
❑
❑
❑
❑
None
❑
present - 23 CCR 16 2638,
Yes
HSC 6.7 25290.1, 25290.2,
25291
2060015
Sensor located in the
RD
proper position /location -
®
❑
❑
❑
❑
❑
None
❑
23 CCR 16 2630(d), 2641(x)
Yes
2030062
Facility is in compliance
with not tampering with or
RD
disabling leak detection
®
❑
❑
❑
❑
❑
None
❑
devices or alarms - HSC
Yes
6.7 25299(a)(9)
2060022
System constructed with
a monitoring system
capable of detecting entry
®
❑
❑
❑
❑
None
into secondary
containment - HSC 6.7
25290.2(d)
2030034
Tag /sticker on affixed
monitoring equipment
being certified, repaired,
®
❑
❑
❑
❑
❑
None
or replaced - 23 CCR 16
2638
VPH Monitoring VPH
2030065
Interstitial monitoring of
the annular spaces of the
RD
UST is properly
❑
❑
®
❑
❑
❑
None
❑
maintained - HSC 6.7
Yes
25290.1(e)
2060023
System constructed with
a monitoring system
capable of detecting entry
into secondary
❑
❑
®
❑
❑
❑
None
containment - HSC 6.7
25290.1(d)
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
0
0.0
SOC
Comments
No
10
cc
0
0.
CO 0
Z
0
Z
Line Leak Detector
2060012
Line leak detector
installed on pressurized
RD
piping system - HSC 6.7
❑
❑
❑
R
None
❑
25290. 1 (h), 25290.2(g),
Yes
25291(1), 25292(e),
2636M(2)
2030026
Line leak detectors detect
a 3 gph leak and/or
RD
audible and visual alarm
0
1:1
❑
1:1
1:1
❑
None
[:1
function properly - 23
Yes
CCR 16 26360(6),
2666
2030027
Turbine shuts down when
a leak is detected or
RD
when line leak detector is
❑
❑
N
❑
❑
❑
None
❑
disconnected - 23 CCR 16
Yes
2666(c)
2030025
Pressurized piping able to
detect a 3.0 gph leak
RD
within an hour, and
None
❑
restricts the flow or
Yes
alarms - 23 CCR 16
2636(0(2)
Secondary Containment
2060010
UST storing a hazardous
RD
substance has secondary
Z
❑
❑
❑
❑
❑
None
❑
containment - HSC 6.7
Yes
25292
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
0 0.0
soc
Comments
No
a
0
(L
W.,
%. to
01 0
Z
0
Z
2030008
UDC, sumps, and/or
other secondary
containment in good
❑
❑
❑
❑
❑
None
condition and/or are free
of debris/liquid - HSC 6.7
25290.1, 25290.2, 25291
2030040
Secondarily contained
RD
piping maintained to allow
Z
❑
❑
❑
❑
❑
None
❑
liquid to drain into sump -
Yes
23 CCR 16 2630(d), 2641 (a)
2060006
Secondary containment
piping slopes back to the
None
collection sump - 23 CCR
16 263(c)
2030047
Secondary containment
maintained tight and has
been confirmed by testing
Z
E:]
❑
❑
None
- 23 CCR 16 2662; HSC 6.7
25290.1(c)(2), 25290.2(c)(2),
25291(a), 25292(e)
2030060
Entry fittings in secondary
containment for UST
system maintained
E
❑
❑
1:1
1:1
❑
None
tight/sealed - 23 CCR 16
2630, 2635(d), 2636(c),
2666
2060020
Spill bucket is installed
and has a functional drain
RP
valve or other means to
Z
❑
❑
❑
❑
❑
None
❑
remove liquid - 23 CCR 16
Yes
2635 2665
2030054
Spill bucket maintained in
RP
good condition and free of
Z
E:]
E:]
F-1
❑
❑
None
❑
debris and/or liquid - 23
Yes
CCR 16 2635(b), 2715(c)(2)
2060019
Spill bucket to has a
minimum capacity of five
None
gallons - 23 CCR 16
2635(b), 2665
Overfill
2030035
UST system is operated
to prevent unauthorized
RP
release, including spills
Z
❑
❑
❑
None
❑
and overfills - HSC 6.7
Yes
25292.1 (a)
2030036
Overfill prevention system
has not been overridden
RP
and meets overfill
Z
❑
F-1
❑
None
❑
requirements - 23 CCR 16
Yes
2635(b)(2), 2665 1
1
1
1
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
4-
0
0 0
SOC
Comments
No
0
:)
4
a
Cn
0
ID =
0 o
z
0
z
:)
1 0
>
On Site
Records
Certifications
2030023
Required designated
operators or contractors
maintain a proper and
N
1:1
❑
None
current ICC certification -
23 CCR 16 2715
2030024
Service technician,
installer, and/ or
employee maintain a
E
❑
❑
❑
❑
❑
None
proper license - 23 CCR
162715
2030031
Employee or contractor
obtained and maintained
proper manufacturer
❑
❑
F-1
❑
None
certification - 23 CCR 16
2715
2010007
Submit/maintain current
Certificate of Financial
Responsibility /mechanism
of financial assurance -
Z
F-1
❑
1:1
❑
❑
None
23 CCR 16 2711; 23 CCR
18 2808.1, 2809-2809.2;
HSC 6.7 25292.2; HSC
6.75 25299.30-25299-34
Designated Operator
2010004
Copies of DO inspections
for last 12 months and list
of trained employees
Z
❑
❑
F-1
F-1
❑
None
maintained - 23 CCR 16
2715
2030013
Designated operator
properly conducted the
monthly inspection and
Z
❑
❑
❑
❑
❑
None
the reports are complete -
23 CCR 16 2715
2030010
DO notified operator of
any condition observed
during the monthly
❑
None
inspection that may
require action - 23 CCR 16
2715(d)
2030012
DO employee training
performed, current for at
least one employee on
N
❑
F-1
F-1
❑
❑
None
site, and a log kept - 23
CCR 16 2715(c)(6), 27150
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
4-
0
4) 0
SOC
Comments
No
a
0
(L
e!
wa
Z
0
Z
C)
I I X
4) >
f
Logs
2030001
Leak detection alarm
logs, maintenance and
RD
records of appropriate
El
❑
❑
❑
None
❑
follow-up actions
Yes
maintained - 23 CCR 16
2632, 2634, 2712(b)
Maintenance/Tests
2010008
Monitoring, maintenance,
repairs, linings, and
RD
upgrade records
ED
EJ
1:1
El
El
❑
None
❑
maintained for the proper
Yes
time period - 23 CCR 16
2712 (4)
Documentation
2030033
Failure to maintain on site
an approved monitoring
❑
El
EJ
❑
❑
None
plan - 23 CCR 16 2632,
2634, 2711, 2712(1)
2030037
Written agreement
between the tank owner
and tank operator to
monitor the tank system
0
❑
❑
None
is maintained - 23 CCR 16
2620(b); HSC 6.7
25284(a)(3)
2030061
Suspected or actual
unauthorized release
RD
reported in appropriate
None
❑
time frame - HSC 6.7
Yes
29294,29295 1
General Ope'ratin'g Re'quire'ments
Permit Condition/Approval
2030039
Compliance with all
operating permit
None
conditions - 23 CCR 16
2712; HSC 6.7 25299
2030059
UST system maintained
in accordance with
exclusion/exemption
❑
❑
❑
None
status - HSC 6.7 25281.6,
25283.5
2030014
Owner/Operator received
approval and has
implemented a training
❑
❑
None
program at an unstaffed
facility - 23 CCR 16
2715(0(2
2030015
Facility exhibited that the
method used to monitor
the tank meets the
monitoring methods in
None
2643(f - 23 CCR 16 2643
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
c
SOC
Comments
No
a
o
0
a
m�
o
,.
Z
O
Z
U
D �
Red Tag
2030045
Red Tag information is
legible and has not been
❑
❑
®
❑
❑
❑
None
tampered with - 23 CCR
16 2717.1(8
2030044
Facility did not allow for
deposit of petroleum into
a UST that has a red tag
❑
❑
®
❑
❑
❑
None
affixed to the fill - 23 CCR
16 2717.1(
Install /Repair
2060024
UST system is made of or
lined with materials that
are compatible with the
®
❑
❑
❑
❑
❑
None
substance stored - 23
CCR 16 2631.1
2060021
Striker plate installed and
positioned correctly - 23
®
❑
❑
❑
❑
❑
None
CCR 16 2631(c), 2662 d
❑ There were no violations noted for this inspection.
®This report shall serve as a "NOTICE TO COMPLY" for Minor Violations, and a "NOTICE OF VIOLATION" for
Major violations. You are, hereby, ordered to correct the above noted violations within 30 days, or according to
correction summaries provided. Formal enforcement and/or penalty assessment may be initiated for any
violations noted, and for those not corrected in a timely manner. (NOTE: If this is a preliminary report, a final report
will follow.)
Inspectors Signature:
Date. 12, `
Inspector: Enter # of Violations: RD: e::�:> RP
Check one box for facility Significant Operational Status (SOC) to be reported to SWRCB and US EPA:
�FSOC with both Release Detection and Release Detection (Facility has no Release Prevention and no Release
Prevention Violations)
❑ Not in SOC (Facility has both Release Prevention and Release Detection Violations)
❑SOC with Release Detection only (Facility has no Release Detection violations but one or more Release Prevention
violations)
❑ SOC with Release Prevention only (Facility has no Release Prevention violations but one or more Release Detection
violations)
Underground Storage Tank Program - DW Inspection Report . v 2.0
Notice Of Violation C /ass l and /or Class: l Violations were found during.this inspection as
noted; in the fohl6wiing Summary of Violations.
The violations indicated in. this inspection report must be corrected within 30 days, unless
otherwise noted
Formal enforcement will be initiated for all Class l Violations, and, for any Class l violations not
corrected within the required timefra me, This, report does not: represent that there are no other
violations at -this facility. A re-inspection .ma occur to determine compliance status,
SUMMARY OF VIOLATIONS
helm REQUIREMENT FOR CORRECTION DATE FOR
VIOLATION
# OF VIOLATION : CORREC TION'
f .. lys 141"-
-3..'
Inspectors
Recei ed, by. I/
Signature:
Phone: -,
Print: Name:
Date: Date:
KPS #8447 .
White - Business Copy Yellow — Business: Copy to be' sent in after Return -to- Compliance Pink - Prevention Services Copy
IVIINUK "V IULA I:IUN i
Owner /Operator:
Facility:
Address:~
n There were NO violations observed during this inspection.:.
Notice to Com l : 'Minor Violations wer -e found during. this ,inspection..as noted in the following
Su►nmary of Violations.'
The violations indicated In this ` i:nspection report must` be corrected `within 30 days, unless
otherwise noted.
Formal enforcement may bey initiated for any.violations noted; and for those not corrected in a,
timely, manner This report' does not represent that there are no other violations at. this facility A.
re- inspection may occur to determine compliance status.
"
,
CERTIFICATION OF RETURN TO "COMPLIANCE
. I norfefv +ham+ +ho'�iinl�+i.nn� nn�e�cl'ahnvA nn fhic Nnfirrn fn r...mm�ivit. lmmarv: �f "Vlnlatlnn�s. i1aVe bEGn :.
SUMMARY:.OF VIOLATIONS
Item'
REQUIREMENT FOR CORRECTION OF..
REQUIREMENT
: :. DATE FOR :
#
:
: ` CORRECTION
•5 .
'..
P S t.C..� �.+ 'vv l A 3 ,.v
�„i
° 6.
nspectors -'�
I$ig nature C., _- ----..
Received `by. J. -} .
i -•;` ;
.-; ..:
Phone:
Print Name
Date:_
z
Date:
"
,
CERTIFICATION OF RETURN TO "COMPLIANCE
. I norfefv +ham+ +ho'�iinl�+i.nn� nn�e�cl'ahnvA nn fhic Nnfirrn fn r...mm�ivit. lmmarv: �f "Vlnlatlnn�s. i1aVe bEGn :.
Owner/Operator". .': u2 ° v, i. . .
Address
There. were IVO Violations observed during this inspection
Notice -.to: Minor Violations were found during his inspection as noted in the followin j
Summary of Violations.
The :violations. indicated :in this' inspection report must b do rrected within 30 days, unless
:otherwise noted.
Formal :enforcement may be initiated for any, violations noted, and for.those .not corre �. cted a
timely :manner: This report does not represent that there are no other vio. tlons at this faci.iity. A
.re- inspe:ction..may.occur to deto.rmfne :compliance status:
C
V
BAKERSFIELD FIRE DEPARTMENT
HAZARDOUS WASTE
wr`-
COMMENTS
UNIFIED PROGRAM CONSOLIDATED FORMS
g B R S F 'I D
Prevention Services
_
2101 H Street
SMALL QUANTITY HAZARDOUS
AR T
Bakersfield, CA 93301
Phone: 661- 326 -3979 6.61 -852 -2171
WASTE GENERATOR INSPECTI
•Fax:
Hazardous waste determination made for all wastes
0 Analysis ,Generator Knowledge [CCR 66262.4.01
3030005
Facility Name:' r..'.
Date:
Site Address: c ti's "CZ A7 ~
Time In: . Time Out:
Owner /Operator: : i w 1' l t l .... �, '� �� .
Phone:
EPA ID .#, Z6
Type of Inspection
Facility personnel demonstrate training /awareness [CCR 66262.34(d)(2)] .
0 Routine 0 Re- inspection/Follow -up XCombined Routine
Inspection Joint Jnspection
0 Complaint 0 Focused 0 Other
CONSENT TO INSPECT GRANTED BY (Name / Title):
Manifests /Consolidated Manifest receipts complete [CCR 66262.23(x)]
Lpection may involve obtaining photographs, review and copying of rec 4ds, and determination of compliance with hazardous waste handling requirements.
Al — !11— T TT — M ;nnr.1T ;nlnt;rnn
C
V
HAZARDOUS WASTE REQUIREMENT
N/A
CERS
Violation #
COMMENTS
Recordkee in documentation
r
Generator has an EPA ID number [HSC 25143.131
3010002
Hazardous waste determination made for all wastes
0 Analysis ,Generator Knowledge [CCR 66262.4.01
3030005
Contingency plan information posted near phone [CCR 66262.34(d)(2)]
3010022
Facility personnel demonstrate training /awareness [CCR 66262.34(d)(2)] .
3020001
Manifests /Consolidated Manifest receipts complete [CCR 66262.23(x)]
3010008
Blue: copy(s) of manifest mailed to DTSC [CCR 66262.23(a)(4)]
1
3010011
Bills of Lading/receipts available [CCR 66262.40(a)]
3010010
LDRs available and complete [CCR 66268..7(a)]
3030006
Onsite recycling reported using UPCF . [HSC 25143.10]
3030001
Container /tank management
Containers are in good condition [CCR 66262.34(4)(2)]
3030013
.'Containers are closed except when adding/removing [CCR66262.34(d)(2)] "
3030017
Satellite containers at or near point of generation [CCR 66262.34(e)(1)(A)]
---
Empty containers are empty [CCR 66262.34(f)]
3030007
Containers inspected weekly [CCR 66262.34(d)(2)]
3030019
Tanks inspected daily [CCR 66262.34(d)(2), 40CFR 265.2011
3030027
One container. per waste stream at satellite area . [CCR 66262.34(d)(2)]
.3030022
Exclude recyclable materials stored in accordance with local
ordinance /hazardous materials codes [HSC 25143.10]
3010016
Accumulation Time Limits
Waste is accumulated not more than 90/180/270' [CCR 66262.34(d)]
3030010
Empty containers managed within one year [CCR 66262.34(d)]
3030010
Universal waste accumulated. less than one year [CCR 66273.15(a)]
3030011
Used oil filters offsite within 180 (1 year <1 ton) [CCR 66266.130(c)(4)]
3030004
Pb -acid batteries offsite within 180.(1 yr. < 1 ton) . [CCR66266.81(a)(3)]
3030002 .
Labeling/Marking
Containers are properly labeled [66262,34(f)]
3030007
Excluded recyclable materials marked properly ` [HSC 25143.9(a)]
i
3050005
Universal waste container properly labeled (CCR 66273.341
3030008
Used oil filters marked "drained used oil filters" [CCR 66266.1301
3030004
Date written on spent lead -acid batteries.. [CCR 66266.81(a)(6)(B)]
3030003
"Used Oil" marked on all used oil tanks /containers [CCR 66279.21(b)]
1
30,30007
Tank marked with `.`haz waste" , contents, start date [66262.34(f)]
3030007
Treatment, Transport and Disposal/Other
Have permit/authorization to do treatment [HSC 25136.21
3040003
Waste sent with authorized transport (gen. eligible) [CCR 66263.411.
3050001
Waste disposed of to. authorized point/party [HSC 25189.5(a)]
3050002
Failed to properly Handle a fiance wastes [HSC 25212(a)]
Fire Protection [66262.34(d)(2)]
3030032
Print and sign in this box for receipt of this report. Signature does not imply agreement with findings only receipt of report. .
'
INSPECTOR-.
POST INSPECTION INSTRUCTIONS:
• 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 St. Bakersfield," CA 93301
White = Business Copy Yellow Station Copy
Signature (that all violations have been corrected as noted)
Date
FD2171 (Rev 9/14).
Pink- Prevention Services Copy,
M. ROUTINE ❑ COMBINED ❑ JQINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT CI RE- INSPECTION
C . V = ompiance OPERATION CERS
v= Violation; 1,11 Minor Violation COMMENT
/APPROPRIATE PERMIT ON HAND (BMC• 15 65 080) 3010001
Inspector:..
POST INSPECTION INSTRUCTIONS:
• 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:. Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services; 2101 H Street, California 93301
Date
White — Business CoDv Yellow - Station CODV Pink— Prevention Services FD2155 (Rev 8H14) . . .
BUSINESS PLAN CONTACT. INFORMATION ACCURATE (CCR: 2729.1) .
1010008
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT. OCCUPANCY (CBC 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729:3)
:1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729:2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1),
VERIFICATION OF SIDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING (CFC; 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
SITE DIAGRAM ADEQUATE &.ON HAND (CCR: 2729.2)
1010005
NY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NQ
ii nature ofRece'' _
Explain:
Inspector:..
POST INSPECTION INSTRUCTIONS:
• 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:. Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services; 2101 H Street, California 93301
Date
White — Business CoDv Yellow - Station CODV Pink— Prevention Services FD2155 (Rev 8H14) . . .