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DF,8;IGWATJ9J.D OPERATOR FACILffY W"LOYBE TRAIMNAG RECORD
Foruw by Un&bcxAIemIwrAgaWej or whemapprovedbyyvarLocWJurbdiaiou
AuAvrity ated: 77dr 23. Div. 3, C&. 16 Cal is Code vfRoguWmu (MM
Facility NA
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lzw4 y Site Addrea: 31-_ZS ....... 'City: P>zZw&r, CA,
Sootion 2715 of Tide 23, C. fm Code of pktjonjs, rcqm= oba Dos!Ku" Uw%oumud- ftuge, Talc Opwatan
prm& tmluimg to Ea, Ay t=VIqy= who Lave mponft-Wfifift a=oiated with dit *&*fion or uwfibname of
WRIervound sores tw* OM) systeam 116 w6aing Vuy t be p* iced by J* 1, 2005, and evmy 12 nmibs tbervdter.
Por fimffiV mj90yc= hucd after July 1. 2005, thw- iintml ftahiing nag be pwvWdwiffi7k 30 -days of dc date of-bbre- At
1"d ow of tbe htWity ov*qr= ant &wmg opmtmg hot= aunt lave ewrmt UdIUM. This Uawwg must twfudo. Nut
is not umhwto, des fonewft items nsqmiriod in 23 cm soaio= 2715(f)(1) sad (2):
Cl Op wation of t1w UST zysWw in a manner cansistmt wAb ft fhoft"s I t tp=60w,
13 The woqoes Me with rcgud to UST monitoring oquipumus specified in the vdUm UST A"w4ng PINX
0 - IU employee's tole with we&ud to q4h eW overffils m qmi&d in the vvritl= UST Rcqmm Plan-,
0 Naue(z) of oontact p"Dv(x)Aw.a=Ucwics and moii�ariug cquipmmt ahrmw,
0 Fow facilWes that am not fiteifity emptoyea wapotm-biUdw as WvifiW in. the � PV=
approved by the toed UST xogWakwy *ga=y.
23 CC R § 2715MP) mpirm that -a fist of employees who tavv be= ftp�md 'by the D*pnled Uudugi+ uad Sb=W. T=k
OPWA*s). be mainft hied on4te. or off -site at a mdily-awilaW loca6aa if mwomd W " IOW uW provkIed to
the local agency upon requea Cmplehbu ofthis fbim vdH mbffy UST ftumg record kup% requk-emmt& 11he fonewing
cu*oycwrhm bow uaiucd as requimd by 23 = Sw6m 2715(fXl) and (2):
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UNIFIED PROGRAM INSPECTION CHECKLIST
S E CTI 0 N 1: Hawdous Materials Business Plan
Insinection
BAKERSFIELD FIRE DEPT.
rVPrevention Services
-Pf- 2101 H Smet
FINE
r,PA ARV TR Bakersfield, CA 93301
A%000k, Tel., (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME
INSPECTPN D TE
INSF' TIME
V�Violation; Jx minor
4 ,7
96EQTJQN
V
ADDRESS
PHONE NO,
NO OF EMPLOYEES
(Z!,AULFCf'(1-A_a/A
APPROPRIATE PERMIT ON HAND 15,65.080)
FACILrrY CONTACT
BUSINESS ID NUMBER
onsenj %1 N to
1010Q0
fR; . .....
p,
;2PJ 4*1 ;A rP
t
0 0, A"
❑ ROUTINE ❑ COMBINE[) ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT Q RE-INSPECTION
C V z:-:GO—mpliance OPERATION
CERS
V�Violation; Jx minor
ViDlation
COMMENT
X
APPROPRIATE PERMIT ON HAND 15,65.080)
BUSINES$ PLAN CONTACT INFORMATION AOCLJRAT✓ (OCR: 2729.1)
1010Q0
VISIBLE ADDRESS (GFC, 505.1, BMC: 15.62.020)
J0
—
CORREOT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATE-FtIALS (CCR: 2729-9)
101DO04
VFamr-ICATION OF QUANTITIES (GOR: 2729.4)
1010006
VrERIFICATION OF LOCATION (CCN: 2722.2)
PROPER SEGREGATION OF MATERIAL AFC: 2704-1)
VERIFICATION OF SDS AVAILABILITY (COR: 2729.'C( )(b))
ERIFICATION OF HAZ MAT TRAINING (CCR: 2732)\.,
iop_0002
-4�
VERIFICATION OrABATEMENT SUPPLIES& PROCEDURES (COR:273i(0))
EMERGENCY PROCEDURES ADEQUATE (CCR- 2781)
1()10010
CONTAINERS PROPERLY LABELED (OCR: 65202,34(1), OFG: 2703-5)
500007
HOUSEKEEPING (CFO: 304.1)
FiptiE PROTECTION (CFO: 903
3030032
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2'729.2)
0100o'S
ANY HAZARDOUS WASTE ON SITE? -YES ❑ NO
Explain:
L
Imp"ton
POST ENSPECTION INSTRUCrIONS.
• Comet the violaticu(s) noted above by
a Within 5 dayt, of couecting all of the violations, sigft and rrtum a copy of this page to., violations have been oQxrected as noted)
B.ak=fxel4 Fire DW., PrevcrWon Services, 2101 H Sweo, California 93301
Date el - "q- -7 - A'JL
White - Ensiness Copy yellow - soon Copy Pink - Freventiot Services FD2155 (Rev 9/114)
HAZARDOUS WASTE BAKER,, FIELD FIRE DEPARTMENT
UNIFIED PROGRAM CONSOLIOATM FORMS Prevenilo' n1 1: Services
2101 H Stmet;
SMALL QUANTITY- HAZARDOUS g r Bakersfield.. &93301
WASTE W Q�NERA'�t R INSPECTION. . *APTIEW T Phone, +661 - 326 -3979 * Fax: 661- 652 -2171,
,facility Nuw,. _- _ . Date: QZ 7-714p col
Sitc Address: e`'ar, - / F-
akwl Time In; 9 60 Ti= Cut:
Owner/Operator
...Qf 13Ugetion
Q ftutine 0 Re wspeetion/Voltow -up ombiaed Routine
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l`tSXNT TO INSPECT GRANTED By (.Name f Title);
Phi =;
EPA III # C-4 QW.V
gectinn 0 CatraplWAT 0 Foeui vZ 0 Othif
POST 1148MCTION INSTRUCTIONS:
+ Cm=ct fbe, violadon(s) noted above by ' 3igttgruate viol asts #taus been corxecttd as noted)
+ Withizi 5 days of correctuas alt of the violations, sign and rctum a copy of this page to;
pakersfield Fire Oept,, Preyentim Services. 2101 H St, Bakersfield, CA 93301 !Date
FD2171 (Pev Ovj4)
White - Business Cove Yellow- Station Copt Pink. Prevention Se><Aces Copy
BAKERSFIELD FIRE DEPARTMENT
UNIFIED PROGRAM INSPEC110N CHECK11-JS• Prevention Services Division
2101 H Street
FIRE Bakersfield, CA 93301
Underground Storage Tank Program j(A!iJft0?7T'iN F r Phone: 661-326-3979
AW1506- F8X.' 661-852-2171
NOTICE To COMPLY / SUMMARY OF VIOLATIONS
MINOR VIOLATIONS
Owner/t erator: -t:�yAkLA,(),j
Facili!y: Aj? Co
Address; S [ = C
❑
There were NO violations observed during this inspection.
'10
CORRECTION
Notice to Comply.- Minor 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 may be initiated for any violations noted, and for those not correoted in a
timely manner. This report does not represent that there are no other violations at this facility. A
OaV-W.
SUMMARY OF VIOLATIONS
Item
VIOLATION
REQUIREMENT FOR CORRECTION OF
DATE FOR
#
VIOLATION
CORRECTION
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I-An
Inspectors
Re6eived by-
.i nature:
[Phone:-
Print Name.
[Date:
Date:
CERTIFICATION OF RETURN TO COMPLIANCE
White - BuslnsS'S COO yi-11cm — ril Iptin'=qq r1nn-kr fn hay Qchnf o*=r P =41 1rn s-^ -,:, rFt-1- _,__.._..1:... . —