HomeMy WebLinkAboutFMC FORMS 2016Kern Business Forms (661) 325 -5818 — KBF -7320
BAKERSFIELD FIRE DEPARTMENT
FIRE PREVENTION INSPECTION Prevention services
B EFIRE L D 2101 H Street
x
ARTM r Bakersfield, CA 93301 -
Phone: 661- 326 -3979 • Fax: 661- 852 -2171
DISTRICT
BLOCK NO.
DATE�� J
C�
FEE
FACILITY` AD RESj� _ /7
f 4 # E >P2 `? �'G 7
CITY, STATE, ZIP
}' r (+fir f i ,?3;�) d
FACILITY NAME _
MANAGER'S NAME
PHO,� jr 4�.•,
BUSINESS OWNER'S NAME AND ADDRESS
CITY, STATE, ZIP
PH NO.
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS
CITY, STATE, ZIP,
PH NO.
OCC TYPE
OCC LOAD
NO. OF FLOORS
HIGH RISE BLDG
NO"y,
RISER DATE
❑ YES
CORRECT ALL VIOLATIONS VIOLATION
REQUIREMENTS
CHECKED BELOW NO.
1
Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (CFC
COMBUSTIBLE WASTE / DRY
304.1.1
VEGETATION
2
Provide non - combustible containers with tight fitting lids for the storage of combustible waste and
rubbish pending its safe disposal. (CFC 304.3.2) Note: applies to containers over 40 gallons.
COMBUSTIBLE STORAGE
3
Relocate combustible storage to provide at least 3 feet clearance around motor fuse box /fire door .(CFC
605.3)
Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the
4
top to the extinguisher not more than 5 feet above the floor. (CFC 906.5 & 906.9)
EXTINGUISHERS
5
Provide and install.(amount) approved (type & size) _ ________ ___ __ _ ___ portable fire
extinguisher to be immediately accessible for use in (area) ----------------------------- (CFC
TA .BLE 906.3(1))
6
Re- charge all fire extinguishers. Fire extinguishers shall be serviced at least once each year, and /or
after each use, by a person having a valid license or certificate. (CFC 906.2)
7
Provide and maintain "EXIT" sign(s) with letters 6 or more inches in height ;over each required exit
SIGNS
(door /window) to fire escape. (CFC 1011)
$
Provide and maintain appropriate numbers on a contrasting background and visible from the street to
indicate the correct address of the building. (CFC 505.1)
9
Repair all (cracks /holes /openings) in plaster in (location) ----------- ------------
FIRE DOORS
Plastering shall return the surface to its original fire resistive condition. (CFC 703.1)
FIRE SEPARATIONS
10
Remove /repair (item & location) ----------------------------=----------------------------
Self- closing doors shall be designed to close by gravity, or by the action of a mechanical device, or by an
approved smoke and heat sensitive device. Self - closing doors shall have no attachments capable of
preventing the operation of the closing device. (CFC 703.2)
11
Remove all obstruction from hallways. Maintain all means of egress free of any storage. (CFC 1028.3)
EXITS
12
Provide a contrasting colored and permanently installed electric light over or near required exit
(location) ------------------------------ to clearly indicate it as an exit.. (CFC 100.6.3)
Remove all storage and /or other obstructions from .fire escape landings and stairways stair shafts. (Fire.
STORAGE
13
escapes /stair shafts are to be maintained free from obstructions at all times.) (CFC 1003.6)"
14
Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved
ELECTRICAL APPLIANCES
electrical outlets where needed. (CFC 605.5)
is
Remove multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (CFC
605.4)
OUTDOOR BURNING
16
Recreational fires or open burning. CFC 307.1
FIREWORKS
17
Violations of Section (CFC 5608.1) & 8.44.040 (B.M.C.).
OTHER
18
)14 f, c". 'r12C24 f � 1 ♦ 'i » ' ~ 1
CORRECTION DATE
Correct the violations noted above by: /,,,,,} ,%.
LEGEND:
C.F.C. CALIFORNIA FIRE CODE
C.B.C. CALIFORNIA BUILDING CODE
CUSTOMER
B.M.C. BAKERSFIELD MUNICIPAL CODE
N.F.P.A. NATIONAL FIRE PROTECTION
.
(Signs re) (Please Print Name Legibly, T le)
° {
NO.: i� _ tv
ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
INSPECTOR: �--
01 IRARAADV t%P Xllnl ®Tit')Kl-lq .
CERTIFICATION OF- RETURN TO COMPLIANCE
KPS #8446
V- 11^.A, — Pt minzeQ r.nnv to hp sent in after Return -to- Compliance mnK — vrevenuon cervices Lopy
-- ... --
REQU " "IREMENT FOR CORRECTION OF.
DATE FOR
Item
VIOLATION
V
VIOLATION
CORRECTION
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CERTIFICATION OF- RETURN TO COMPLIANCE
KPS #8446
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CLASS HAND, CLASS I VIOLATIONS
Owner/Operator::: --le
Facility:� c Zls <2196,r)
Address: s i ^4l 77 r �~
KPS #8447
White = Business Copy Yellow - Business Copy to be sent in after Return -to- Compliance Pink. — Prevention Services copy
No Lice Of Violafion: (;Classy and /or Cass l Violations were found during this inspection as
noted in the following 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 I.-Violations:, and :for any. Class. l violations not
corrected within the required timeframe. This report. does not represent that there are no,other,
violations at this facility. A re- inspection may occur to determine compliance status.
KPS #8447
White = Business Copy Yellow - Business Copy to be sent in after Return -to- Compliance Pink. — Prevention Services copy
BAKERSFIELD FIRE DEPARTMENT
HAZARDOUS WASTE — Prevention Services
UNIFIED PROGRAM CONSOLIDATED FORMS B E R S F I D
FIRE
2101 H Street
Bakersfield, CA 93301
HAZARDOUS WASTE GENERATOR D, ARTM T phone: 661 - 326 -3979 •Fax: 661- 852 -2171
INSPECTION REPORT
� r ` ..r.' .r_; r L...i w; Date
Facility Name r r r =.. �� .:f e �:, _� �'T �.,
Site Address t-
Time-In Time Out
h
Owner /Operator ; .. ", i _ :" Y s .. j-; '� Yj c ;; L, ^� Phone fi ` 1 - 6, 3Y - .5 e.5 Misc.
Type of Inspection Inspection Consolidation EPA ID # FY.^ , r`, 96 _t =w
[��':outine ❑ Re- inspection/Follow -up ❑ Combined Routine Inspection ❑ Joint Inspection ❑ Complaint ❑ Focused ❑ Other
❑ Integrated or Multi -Media Inspection CUPA Facility ID#
2 CONSENT TO INSPECT GRANTED BY (Name / Title). �
Inspection may involve obtaining photographs, review and copying of records, and determination of compliance with hazardous waste handling requirements.
Ao na of
I - Class
I
Violation,
11-
Class 11 Violation, 1v1 - 'vi-nor v 101auvu
COMMENTS/NOTES/DOCUMENT(S) REVIEWED
MISSING INFORMATION/ UNRESOLVED ISSUES
I
II
M
Code :1
HAZARDOUS WASTE REQUIREMENTS
Recordkee in documentation Ar
GR01
Generator has an EPA ID number
GR02
Hazardous waste determination made for all wastes
❑ Analysis &Generator Knowledge<
�
GR03
Contin ency Ian information posted near hone`
f
GR04
Facility personnel demonstrate training/awareness
Manifests /Consolidated Manifest receipts complete
GR05
GR06
Blue copy(s) of manifest mailed to DTSC
TSDF signed copy of manifest available w /in 35
days of waste ship ment
`
GRO7 .
GR08
Bills of Lading./receipts available
GR09
LDRs available and complete
GRID Onsite recycling reported using UPCF
Container /tank mans em mt
GCO1 Containers are in good,condition
GCO2
Containers are closed exce t when adding/removing
GC03
Empty containers are empty°
GCO4
Containers inspected weekly
GG05
Tanks inspected daily
GC06
Satellite containers at or near point of generation
"9
GC07
Satellite containers under control of operator
GCO8
One container per wastestream at satellite area
GC09 ;
Exclude recyclable materials -stored in accordance
with local ordinance/hazardous materials codes
Accumulation Time Limits r
GA01
Waste is accumulated not more than 90/180/270`
GA02
Satellite wastes accumulated for less than 1 year
GA03
Empty containers managed within one year
}f
GA04
Universal waste accumulated less than one year
GA05
Used oil filters offsite within 180 (1 year if <1 ton)
,
GA06
Pb -acid batteries offsite within 180 (1 yr. if < 1 ton)
Labelin arkin
GL01 Containers are ro erly labeled
GL02
Satellite containers have 2' ASD marked once full
GL03
Excluded recyclable materials marked properly
GL04
Universal waste container properly labeled
GL05
Used oil filters marked "drained used oil filters "'
GL06-
Date written on spent lead -acid batteries
GL07
"Used Oil" marked on all used oil tanks /containers
Tank marked with "haz waste" , contents,`start date
GLO8
GL09
Empty containers marked with date emptied
Treatment, Transport and Disposal/Other
Print and. sign in this box for receipt of this report. Signature does
not imply agreement with findings, only receipt of report.
'o ) t
GTO1
Have' errnit/authorization to do treatment
GT02
Waste sent with authorized transport ( en. "eli ible)
f
GDO1
Waste disposed of to authorized point/party
GHO1
Failed to properly handle appliance wastes
1
�
POST INSPECTION INSIRUUJUUN�:
• Refer to the back of this inspection report for regulatory citations and corrective actions
• 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 — Prevention Services Copy
Qnature (that all violations have been corrected as noted)
Date
FD2171 (Rev 11/13)
Yellow— Business Copy
BILLING & PERMIT STATEMENT
PERMIT #
14;--1
.. S
8 Av,. iC R R S F -_t "•L D
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone, 661 - 326 -3979_ • Fax _66 852 -2171
II errnits must be reviewed stamoed, and alqxxoved PRIOR TO BEGINNING
CALCULATION 11 PERMIT TYPE FEE •
❑ Alarm - New & Modification (minimum charge) $280
SITE INFORMATION
LOCATION OF PROJECT
1501 Feliz Drive
PROPERTY OWNER
Bakersfield City School District
STARTING DATE COMPLETION DATE
01/06/16 01/06/16
NAME
John Worley
PROJECT NAME
Monitor Certification
ADDRESS
1501 Feliz Drive
PHONE #
661- 631 -5880
PROJECT ADDRESS
1501 Feliz Drive
�p //�� /�
CITY t�/-C ��r�vC ( �% STATE CA
ZIP CODE
83307
$280
CONTRACTOR NAME: Cal-Valley Equipment
CA LICENSE # 998733
TYPE OF LICENSE: A, Haz
111/30/16
EXPIRATION DATE:
PHONE # 661- 327 -9341
CONTRACTOR COMPANY NAME: Cal-Valley Equipment
FAX # 661 - 325 -2529
ADDRESS: 3500 Gilmore Avenue
CITY: Bakersfield
ZIP CODE: 93308
II errnits must be reviewed stamoed, and alqxxoved PRIOR TO BEGINNING
CALCULATION 11 PERMIT TYPE FEE •
❑ Alarm - New & Modification (minimum charge) $280
ONLY
❑
Over 10,000 scl ft
$0 .028 x scl ft
❑
Sprinkler - New & Modification (minimum charge)
$280
❑
Over 10,000 scl ft
$0 .028 x scl ft
❑
Sprinkler - Minor Modification ( <10 heads)
$ 96 (inspection only)
4
❑
Commercial Hood (New & UL 300 Upgrade Modification)
Additional Hood
$470
❑
Commercial Hood - Minor Modification (add /move nozzle) I
96 (inspection only)
84
❑
Spray Booth (New & Modification)
$470
❑
bove round Storage Tank 1 inspection per installation AST
180 /tank
1
82
❑
Additional Tank ATI
$ 96 /tank
82
❑
Aboveground Storage Tank Removal, Mod,or Inspect'n) ATR
$109 /tank
82
❑
Underground Storage Tank (Installation /Inspection) NI
$878 /tank
82
❑
Underground Storage Tank (Modification) MOD
$878 /site
82
❑
Underground Storage Tank (Minor Modification) MTM
$167 /site
82
❑
Underground Storage Tank (Removal) TR
$573 /tank
84
❑
Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot.
NOTE: $96 /hr for each type of test /per site /per UST system
even if scheduled at the same time
$ 96 /hr (2 hrs minimum) _ $192
�� V
82
❑
Oil well (Installation, Inspection, or re- inspection) X
$ 96 /hr
82
❑
Tent #
$ 96 /tent
84
❑
After -hours inspection fee
$121/hr (2 hrs minimum) = $242
❑
Pyrotechnic (1 permit per event, plus an inspection fee of
$96 /hr during business hours) Py
NOTE: After hours Pyrotechnic event inspection is @ 121 /hr
$ 96 /hr+ (5 hrs min standby fee /insp) _ $576
5 hrs min standby fee ins = 605
84
Re- inspection /Follow -up Inspection
$ 96 /hr
84
❑
Portable LPG (Propane): # of Cages?
$ 96 /hr
84
❑
Explosive Storage
$266
84
❑
Copying & File Research (File Research fee $50 /hr)
$0.25 /page
84
❑
Miscellaneous
84
UNDERGROUND STORAGE TANKS
1,10 1 �z
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
❑ LINE TESTING
XFUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661- 326 -3979 . Fax: 661 -852 -2171
Page 1of1
SB -989 SECONDARY CONTAINMENT
SITE INFORMATION
FACILITY: Bakersfield City School District
NAME & PHONE # OF CONTACT PERSON
John 631 -5880
ADDRESS
1501 Feliz Drive, Bakersfield, CA.
OWNER NAME
Kern High School District
OPERATOR NAME
John
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES X NO
TANK #
VOLUME
CONTENTS
1
10,000
Unleaded
2
10,000
Diesel
TANK TESTING COMPANY
TESTING COMPANY
Cal- Valley Equipment
NAME & PHONE # OF CONTACT PERSON
Jerry Rangel
MAILING ADDRESS
3500 Gilmore Avenue, Bakersfield, CA. 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Jerry Rangel
CERTIFICATION #
Veeder Root: B35460
DATE & TIME TEST TO BE CONDUCTED
01/06/15 @ 9:00 am
ICC #
8160834
TEST METHOD
Industry Standard
APPLICANT SIGNATURE
DATE
12/10/15
r THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
12- /Z.
FD2095 (Rev 03/08)
Cal Valley Equipment
3500 Gilmore Ave
Bakersfield, CA 93308
Customer:
BAKERSFIELD CITY SCHOOL
#28
DIST.
Problem
ATTN: TRANSPORTATION 1501
11/12/2015
FELIZ DR
Bill To:
BAKERSFIELD CITY SCHOOL
#89
DISTRICT
Matthew Hernandez
1300 BAKER ST
ENVIRONMENTAL COMPLIANCE
(661) 631 -5880
(661) 327 -9341
(661) 325 -2529 (fax)
Alt. #:
Map:
Fax: (661) 834 -1551 x john
Cell:
WO Contact: BAKERSFIELD CITY SCI (661) 631 -5880
Co. Contact #1: BAKERSFIELD CF (661) 631 -5880
Co. Contact #2: Yolanda Rivas (661) 631 -4691
Service Work Order
Number: 67700
Alt. WO No.:
Entered: 12/10/2015
Payment Expected by:
PO Number:
Taxable ?:
Check
YES Tax at: Cust
Call Type: Time & Material
Problem: Perform Vapor Recovery Test
Est. Hours /Priority: 0.00 First Call
Special: 16101512= 7/1/15- 6/30/16 Scheduled: 12/10/15 12:00 am Jerry Rangel
Comments:
Perform annual vapor recovery testing and monitor certification testing.
Eqp # & Desc:
Alt # & Loc:
Agreement:
Comments:
Parts:
Comments & Notes:
Customer Notes:
payable lisa Phone 631 -4691
MILES RT- 13
14 MINUTES RT
Work Order Notes:
Scheduled testing with SJVAPCD.
Equipment Notes:
Previous Calls:
Labor:
WO #
Date
Tech
Call Type
Problem
67202
11/12/2015
Erick Cooley
Time & Material
FMU REPAIR/ TROUBLESHOOT
67199
12/2/2015
Matthew Hernandez
Quoted Job
ENVIRONMENTAL COMPLIANCE
67198
11/23/2015
Matthew Hernandez
Quoted Job
ENVIRONMENTAL COMPLIANCE
Work Order 67700
Gasoline Vapor Recovery Test Notification Form
Thank You for Your Gasoline Vapor Recovery Test Notification Application!
District Confirmation Number: I
I The District will issue this number via return email.
Region: I
South
Facility Name:
H Bakersfield City School District
Address:
1501 Feliz Drive
City:
Bakersfield
Facility Permit Number: i
S- 737 -1 -5
Date of Test: 1
F/6/2016
Time of Test:
11:00 a.m.
Category of Test(s):
Compliance
Equipment Startup Date:
Type of Test(s)•
Healy Dispenser Integrity, Clean Air Separator, Vapor-to-Liquid Ratio (V/L), TP-
201.113 (Torque Test), TP-201.1C/D (Drop Tube), TP-201.3 (Leak Decay)
Testing Company:
Cal Valley Equipment
Your Name: 1
Ferry Rangel
Your Phone Number:
661-979-0953
Your Email Address: I
al-valley.com
Remote Name: 7174.202.196.90
Remote User: IF
HTTP User Agent: i
5.0 (compatible; MSIE 9.0; Windows NT 6.0; Trident/5.0)
Notes / Comments: 1F
Date / Time:
Thursday, December 10, 2015 12:11 PM
Page 1 of I
http://www.valleyair.org/eForms/GVRTestNotificationForm.aspx 12/10/2015
11/13/2015 09:27 661-834-1551 B.C.S.D. TRANS. PAGE 01/01
San Joaquin Valley
AIR POLLUTION CONTROL DISTRICT
BAKERSFIELD CITY SCHOOL DI ST
1300 BAKER ST
BAKERSFIELD, CA 93305
HEALTHY Ails LIVING°
November 04, 2015
K
BY -JF"'E G-bLl Ocmcz
Dear Sir or Madam-,
_.—Thi�i3eftff -iato. -n-PtifY Yclu _that4=r2.arm.
facility located at 1501 FELIZ DR, BAKERSFIELD, requires that you perform vapor recovery system
testing at specified periodic intervals. Our records indicate that your facility is required to conduct
the following-test(s) by the due date listed below:
Test Type Due Date
Clean Air Separator January 13, 2116
Healy Dispenser Intergrity Test January 13, 2016
TP-201. I B-($tatic Torque) January 13, 2016
TP-20 1. 1 C\D(Leak Rate) January .13. 2016
TP-201.3(Leek Decay) January.13, 2016.
V/L January. 13, 2016
Please contact d schedule -the. required test(-s� to be completed.'You
your source testing co mpany ar
must notify. the .District at least 7 days prior to testing. Your failure to conduct the test(s), within 30
day.5 of th6 date1ndicated above, will result in legal action, including monetary fines.
Pleate'r6member that'your Permit to Operate requires you to s U'bmit copies of the test results to the
District within 30 days of conducting the test(s), as well as, maintain copies on-site in your
Operations & Maintenance (O&M) manual for a minimum of 6 years.
If you have 'uestions regarding this letter please call Angela Frantz at 661-392-554,11.