HomeMy WebLinkAbout2016 inspection reportUnderground Storage Tank Program
DW Inspection Report
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: GASKO FOOD MART-15-021-101678-Armn Investments
Date:8/08/2016
Address Name: 430 East California Ave-CAL000407920
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
0
SOC
Comments
No
a
0
a.
073
Z
0
z
M
0
W
>
File Review
Facility Tank Information
2030021
Facility has a valid Permit
Tank 1-20000-DW-REG
to Operate from the
Tank 2-1 0000-DW-PRM
CUPA - 23 CCR 16 2712(1);
E
El
El
❑
EJ
❑
None
Tank 3-
HSC 6.7 25284
Tank 4-
2010010
UST Operating Permit
Failure to update annually
Application for Facility
information and Tank
information
❑
0
1:1
❑
❑
F-1
None
submitted/maintained - 23
CCR 16 2711; HSC 6.7
25286(a)
2010001
Current BOE number
submitted to the CUPA
1:1
❑
1:1
❑
❑
None
and/or CERS - HSC 6.7
25286(c)
2030011
UST compliance
statement and/or
Designated Operator
F-1
F-1
❑
❑
❑
None
current certification
submitted - 23 CCR 16
2715(a), 2715(b)
2030046
A complete and accurate
response plan has been
submitted, approved and
❑
❑
❑
None
maintained - 23 CCR 16
2632, 2634(e), 2641(h),
2712(i)
2030041
A complete and accurate
plot plan has been
submitted, approved and
r-1
F-1
❑
❑
❑
Minor
maintained - 23 CCR 16
2632(d)(1)(P
), 2 711 (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)
1:1
❑
❑
❑
F-1
None
within 30 days - 23 CCR
16 2715(a)
Violation
Program Requirement
o
SOC
Comments
No
O
Q
C
O
a
�o
z
O
z
:3
U
W
0
Testing
2030002
Owner /Operator has
tested and certified leak
®
❑
❑
❑
❑
❑
None
detection equipment
annual) - 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
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 2637(1), 2638(e),
2643(g), 2644.1(a)(4)
Install /Repair
2060009
Permits obtained to
install, replace, repair, or
®
❑
❑
F I
R
❑
None
modify part of the UST
system - 23 CCR 16 2712
UST 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(g), 2632(c)(2)(A) &(B),
2633 c , 2636
2030017
Product piping outside the
UDC is fail -safe and shuts
down the pump or
®
❑
❑
❑
❑
❑
None
restricts flow - 23 CCR 16
2636(0(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 2636( (1)
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
o
SOC
Comments
No
O
c
z
O
z
M
0
1z
2030019
Monitoring system in the
UDCs activates an
audible and visual alarm
®
❑
❑
❑
❑
❑
None
or stops the flow at the
UDC -23 CCR 16
2636 (0(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(a)
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
m o
SOC
Comments
No
o
O
a
I'D =
CO o
Z
O
z
D
0
W
o
Line Leak Detector
2060012
Line leak detector
installed on pressurized
RD
piping system - HSC 6.7
®
❑
❑
❑
❑
❑
None
❑
25290.1(h), 25290.2(8),
25291(0, 25292(e),
Yes
26360 (2)
2030026
Line leak detectors detect
a 3 gph leak and /or
RD
audible and visual alarm
®
❑
❑
❑
❑
r-1 r
1-1
function properly - 23
CCR 16 26360(6),
Yes
2666(c)
2030027
Turbine shuts down when
a leak is detected or
RD
when line leak detector is
❑
❑
®
❑
❑
❑
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
26360 (2)
Secondary Containment
2060010
UST storing a hazardous
RD
substance has secondary
®
❑
❑
❑
❑
❑
None
❑
containment - HSC 6.7
Yes
25292
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
° o
SOC
Comments
No
Q
(3
O
a
�o
Z
O
z
M
0
W
�>
2030008
UDC, sumps, and /or
other secondary
containment in good
Z
❑
❑
❑
❑
❑
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
®
❑
❑
❑
❑
❑
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
®
❑
❑
❑
❑
❑
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
®
❑
❑
❑
❑
❑
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
®
❑
❑
❑
❑
❑
None
❑
remove liquid - 23 CCR 16
Yes
2635(b), 2665
2030054
Spill bucket maintained in
RP
good condition and free of
®
❑
❑
❑
❑
❑
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
®
❑
❑
❑
❑
❑
None
❑
and overfills - HSC 6.7
Yes
25292.1 a
2030036
Overfill prevention system
has not been overridden
RP
and meets overfill
®
❑
❑
❑
❑
❑
None
❑
requirements - 23 CCR 16
Yes
2635(b (2), 2665
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
o
SOC
Comments
No
O
Q
o
O
a
r..
o
z
O
z
M
v
w
On Site
Records
Certifications
2030023
Required designated
operators or contractors
maintain a proper and
®
❑
❑
❑
❑
❑
None
current ICC certification -
23 CCR 16 2715
2030024
Service technician,
installer, and/ or
employee maintain a
®
❑
❑
❑
❑
❑
None
proper license - 23 CCR
162715
2030031
Employee or contractor
obtained and maintained
proper manufacturer
®
❑
❑
❑
❑
❑
None
certification - 23 CCR 16
2715
2010007
Submit/maintain current
Certificate of Financial
Responsibility /mechanism
of financial assurance -
®
❑
❑
❑
❑
❑
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
®
❑
❑
❑
❑
❑
None
maintained - 23 CCR 16
2715
2030013
Designated operator
properly conducted the
monthly inspection and
®
❑
❑
❑
❑
❑
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
®
❑
❑
❑
❑
❑
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
a o
SOC
Comments
No
o ' � cc
�' °—
z
O
z
V
o>
Logs
2030001
Leak detection alarm
logs, maintenance and
RD
records of appropriate
®
❑
❑
❑
❑
❑
None
❑
follow -up actions
Yes
maintained - 23 CCR 16
2632, 2634, 2712(b)
Maintenance/Tests
2010008
Monitoring, maintenance,
repairs, linings, and
RD
upgrade records
®
❑
❑
❑
❑
❑
None
❑
maintained for the proper
Yes
time period - 23 CCR 16
2712(b)
Documentation
2030033
Failure to maintain on site
an approved monitoring
®
❑
❑
❑
❑
❑
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
®
❑
❑
❑
❑
❑
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
General Operating Requirements
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
d o
SOC
Comments
No
a
o
O
a
0o
z
O
z
M
0
W
05
Red Tag
2030045
Red Tag information is
legible and has not been
❑
❑
®
❑
❑
❑
None
tampered with - 23 CCR
16 2717.1
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: - - ' f Date:
Inspector: Enter # of Violations: RD: � RP:
Check one box for facility Significant Operational Status (SOC) to be reported to SWRCB and US EPA:
® SOC 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
Owne'r/Operator.- PPkt,4A,,' C_
Facil4
Address:
ore NO violations observed during. this.in8pp ion.
There w ct
IM "'01 00 V 11 1
pt� MANI VIM,
M _10 -0 . ......... ..............
found duringthis inspection as noted ]n the, following'-,
-Notice to Com, ly: Minor Vi6lations. were u.
p .13
Summary MM y of Violations. p
The Violations,indidated in this itspecti6h re'Po., rt Ust be corrected -within -304a
days, unless
Otherwise. -noted..
f6 tho o e
Formal enforcement may be initiated r a'ny.vi6lations.noted, and for se.not'c 'rr ct0d in',a.
manner. t, sent that there are no other violations at this. A
timely This re doe s*. no represent
re- inspection may occur to determine compliance status..'
Al 11RAIRAIARY nF: Vlr)l- ATIMIA
CERTIFICATION OF RETURN- TO COMPLIANCE
I certify that the'violati'o'ns. 'noted above on this Notice',to Com-'ply/Summary of Violations have been
corrected. I have personal,ly.examined any documentation, attached. to ther certification to establish that
the violations' have been
Signature:
Title..
Print Name:
Date.
KFti 4;b446
X/ldhittz — Rij_qint=_-,.q (nnv Yellow — Business Cor)v to be sent in after Return-to-Comoliance Pink — Prevention Services Cor)v
BAKERSFIELD FIRE DEPT,
Prevention Services
Inv
2101 H Street
UNIFIED PROGRAM INSPECTION CHECKLIST Bakersfield,, CA 93301
Tel.: (661) 326 -3979
SECTION 1: Hazardous Materials Business Plan Fax (661) 852 -2171
Ins ion
FACILITY NAME
INSPECTION DATE
INSPECTION: TIME
APPROPRIATE PERMIT ON HAND (BMC:15.65.080)
ADDRESS r
PHONE NO.
NO OF EMPLOYEES
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008
FACILITY CONTACT >, -'
BUSINESS ID NUMBER
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
Consent to Inspect Name/Title .
..Y d4 Y... N �. ,- � >... � :.: .... 'S,. ,>. },.. .... < ;,. , ..... .. .. H.. ., ...e u ;"r>xt n ,a i ii'. .n. .;. ✓ s_ . a.�
E, ��>?s.,.:. , Y �. E. F w is -,:,. max.. <.,a ,. ,.v r. � „...� a. .,... x ter, :,r � ., . ,,, « .. Fq<.�.:k#`� w�;y. t� .,. ,,.. .. •<.. �..� >k `�` .�.. a{
,
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.4,4ms� ;'�aay.�?.5"�".�,4 },s;a^',.r.,a �..,.<4,sr �7�$ m,,,, A�..:,..... �v.. Gh>, 4a,1.:F.�«,.���,.:s<.a�4,n,.:., ,�v..a� £ sX.:., E�.,.: s>a.�''..�i.�rc::nrcxb.�.,��&>. n ... ..,,, 3.,L Sx.�s.w k�..a�.�5.,,..d�<:,>. v.:S�i`^c,.a...rt�,.. > &a.c✓rS., u,<.,C „� »<: s: xr..:,H>.!�n�..::....%,:..M.Y'^ <
El ROUTINE JCOMBINED ❑ JOINTAGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V C=Gompliance OPERATION
V =Violation; 1,11 Minor'
CERS
Violation
COMMENT
APPROPRIATE PERMIT ON HAND (BMC:15.65.080)
3010001
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008
r
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 SDS 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
JQ
CONTAINERS PROPERLY LABELED (CCR: 66262.34(1), CFC: 2703.5)
3030007
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES IX NO
Sianature ofRecei t
Explain: n
Inspector: "y Lr
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 Copy Yellow — Station Copy Pink — Prevention Services FD2155 (Rev 8!/14)
HAZARDOUS WASTECRS BAKERSFIELD FIRE DEPARTMENT
UNIFIED PROGRAM CONSOLIDATED FORMS B I D Prevention Services
. 2101 H .Street
SMALL QUANTITY HAZARDOUS T Bakersfield, CA 93301
WASTE GENERATOR INSPECTIO Phone: 661- 326 - 3979 •Fax: 661 -852 -2171
Faclhty Name: `` — C. ° �"- �` 3,� �.-ti ,{ Date:
Site Address: 9? ,� i" J -' Time In:. Time Out:
Owner /Operator: Af /f' r �', =1 ' f/ ` ='r : �1! ! Phone: EPA ID 4r,4,
Tyne of Inspection
0 Routine 0 Re-inspection/Follow-u p . Combined Routine Inspection Q�Jont Inspection 0 Complaint 0 Focused Q Other
Ti
0 CONSENT TO INSPECT GRANTED BY (Name tl
/e): .
.
Inspection may involve obtaining photographs, review and copying of records net ono compliance with hazardous. waste handling requirements.
/ ! _1_'__l_'[T /11 ---T TT-- 11ii:..- Ai:,.1 -4—.
C
V
HAZARDOUS WASTE REQUIREMENT
N/A
CERS
Violation # '
COMMENTS
Recordkee in documentation
Generator has an EPA ID number [HSC 25143.13]
3010002
Hazardous w ste determination made for all wastes
0 Analysis enerator Knowledge [CCR 66262.401
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(a)]
3010008
Blue'co y(s) of manifest mailed to DTSC [CCR 66262.23(a)(4)]
3010011•
/A'
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(d)(2)]
3030013
Containers are closed except when adding /removing [CCR66262.34(d)(2)]
3030017
Satellite containers at or near oint of generation.[CCR 66262.34(e)(1)(A)]
Empty containers are empty [CCR 66262.34(f)]
3030007
Containers inspected weekly [CCR 66262.34(4)(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 ear [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)]
30.50.005
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)]
3030007
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 (en. 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 x^for,receipt.of this report. Signature does hot 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
Signature (that all violations_ have been corrected as noted)
Date
FD2171 (Rev 9/14)
White - Business Copy Yellow— Station Copy Pink- Prevention Services Copy