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Home My WebLink About 2016 inspection reporty >, BAKERSFIELD FIRE DEPARTMENT UNIFIED PROGRAM INSPECTION CHECKLIST It 3 F r 0 Prevention Services Division FIRE 2101 H Street Itltpl� Bakersfield, CA 93301 Phone: 661 -326 -3979 Fax: 661 -852 -2171 NOTICE OF VIOLATION / SUMMARY OF VIOLATIONS CLASS II AND CLASS I VIOLATIONS Owner /Operator: 't>r ,,(xl, -t-�� t±E A � -t _ -t Facility: wNia:jzc Address: Hc)o c:)L_.b a k Q �-, -j�_ ® Notice Of Violation: la ll nd /or Class I Violations were found during this inspection as noted in the followin Summary of Violations. REQUIREMENT FOR CORRECTION OF VIOLATION 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 II 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. SUMMARY OF VIOLATIONS Item # VIOLATION REQUIREMENT FOR CORRECTION OF VIOLATION DATE FOR CORRECTION i Ato ie. i ►A3 pa..- i va —dS 201GO113 P.f�� ! F ,�/ C� gib 3 `� VLZ C .. E-V So Lj%y -k4 SC Inspectors Si nature; . ATz-g>, ice. s Received by: Phone: 0 T-Print Name: Date: q 11 Date: White — Business Copy Yellow — Business Copy to be sent in after Return -to- Compliance . Pink — Prevention Services Copy UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Hazardous Materials Business Plan Inswaion BAKERSFIELD FIRE DEPT. Prevention Services B lil;!E It 8 P t D 2101 H Street *FIRE Bakersfield, CA 93301 ARTN Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME APPROPRIATE PERMIT ON HAND (BMC:15.65.080) ADDRESS PHONE NO. NO OF EMPLOYEES / l�2 BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) 1010008 FACILITY CONTACT BUSINESS ID NUMBER /< ez i9 Ai / d_ P/ A) VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) Consent to Inspect Name/Title 3v':. .^ �v . ... .. ... b G Sectwronl BusinessPlan ;and 0", 'Pro `rarn= ❑ ROUTINE COMBINED ❑ JOINTAGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C V G=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 VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) CORRECT OCCUPANCY (CBC: 401) VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) 1010004 X VERIFICATION OF QUANTITIES (CCR: 2729.4) 1010006 VERIFICATION OF LOCATION (CCR: 2729.2) PROPER SEGREGATION OF MATERIAL (CFC: 2704.1) X 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 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 ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO i natureofRecei t j'2,. f C i-f .A jZ0 7 j Explain: Inspector 6 #4P Q +NJ iE P-. S POST INSPECTION INSTRUCTIONS: • Correct the violation(s) noted above by %C7 —/SO • 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 Street, California 93301 White - Business Copy Yellow - Station Copy Pink - Prevention Services Signature (that all violations have been corrected as noted) Date FD2155 (Rev 8//14) Underground Storage Tank Program DW Inspection Report Permission to Inspect: 121c-HAg<> GILPIAJ BAKERSFIELD FIRE DEPARTMENT Prevention Services Division 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 Fay, 661-852-2171 Business Name: MERCY HOSPITAL SOUTHWEST-15-021-003594 q - -7r Date: /2016 Address Name: 400 Old River Rd-CAD981400237-Dignity Health Inspector Name: Shane Gardner #8248557 Inspection Type: Routine Report: Final CVO = No Violation Observed OUT = Out of Compliance NA Not Applicable UD = Undetermined OS = Corrected On Site RPT = Repeat Violation Violation Program Requirement ro- SOC Comments No 0 0. d cc 030 2 0 z D 0 W File Review Facility Tank Information 2030021 Facility has a valid Permit Tank 1-2600-DW-DSL to Operate from the Tank 2-6000-DW-DSL CUPA - 23 CCR 16 2712(1); Z 1:1 ❑ 1:1 1:1 E] ❑ None Tank 3- HSC 6.7 25284 Tank 4- 2010010 UST Operating Permit Facility and or tank info not Application for Facility acceptd in cers information and Tank information ❑ r-1 ❑ F-1 None submitted/maintained - 23 CCR 16 2711; HSC 6.7 25286(a) 2010001 Current BOE number submitted to the CUPA F-1 F-1 ❑ ❑ ❑ None and/or CERS - HSC 6.7 25286(c) 2030011 UST compliance Expired DO CERTS statement and/or Designated Operator ❑ Z ❑ n ❑ n EJ ❑ None current certification submitted - 23 CCR 16 2715(a), 2715(b) 2030046 A complete and accurate No response plan in cers 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 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) None within 30 days - 23 CCR 16 2715(a) Violation Program Requirement 4- C 0 0.0 SOC Comments No :0:.. :) < a Q) 0 � CL _ 4) I- Q) o Z 0 Z M V W W!; Logs 2030001 Leak detection alarm logs, maintenance and RD records of appropriate ❑ ❑ None ❑ follow-up actions maintained - 23 CCR 16 Yes 2632, 2634, 2712(b) Maintenance/Tests 2010008 Monitoring, maintenance, repairs, linings, and RD upgrade records 1;a El 0 El ❑ None El 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 1:1 El El El E ❑ None status - HSC 6.7 25281.6, 25283.5 2030014 Owner/Operator received approval and has implemented a training ❑ r_1 1Z ❑ ❑ ❑ 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 F-1 ❑ ❑ ❑ ❑ None 2643(f) - 23 CCR 16 2643 Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement W. 0 0.0 S OCC Comments No 9 n < In co 0 �_ a. 0,6.3 I- M O)o z 0 z Testing 2030002 Owner/Operator has tested and certified leak ❑ ❑ None detection equipment annually - 23 CCR 16 2638 2030048 Secondary containment testing conducted every 36 months in accordance ❑ ❑ 1:1 ❑ ❑ 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 f9 ❑ ❑ ❑ ❑ ❑ None after the test - 23 CCR 16 2637(e) 2030064 CUPA was poperly notified within the prescribed number of �a ❑ ❑ ❑ ❑ None hours prior to testing - 23 CCR 16 26370, 2638(e), 2643(8), 2644.1(a) (4) Install/Repair 2060009 Permits obtained to install, replace, repair, or 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 94 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 )E ❑ ❑ ❑ ❑ ❑ 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 2636(0(1) Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement 4- 0 0 SOC Comments No D a 0 CL Co's z 0 z 0 W 4) > 2030019 Monitoring system in the UDCs activates an audible and visual alarm ❑ E-1 ❑ ❑ ❑ None or stops the flow at the UDC -23 CCR 16 2636 (0(1) 2030043 Leak detection equipment Lj.') Aj properly programmed or RD L A, Q— properly operated - 23 None 10 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 oi C) equipment installed for RD L the type of system ❑ E-1 ❑ E-1 E-1 None jEf 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 F-1 ❑ None ❑ devices or alarms - HSC Yes 6.7 25299(a)(9) 2060022 System constructed with a monitoring system capable of detecting entry tr ❑ ❑ ❑ ❑ None into secondary containment - HSC 6.7 25290.2(d) 2030034 Tag/sticker on affixed monitoring equipment being certified, repaired, 1:1 1:1 None or replaced - 23 CCR 16 2638(o 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 ❑ ❑ E ❑ 1:1 ❑ None containment - HSC 6.7 25290.1(d) Underground Storage Tank Program = DW Inspection Report v 2.0 Violation Program Requirement '8 0 0 4) = SOC Comments No M CO 0 '4) (a wa Z 0 Z 0 0 > C1 Line Leak Detector 2060012 Line leak detector installed on pressurized RD piping system - HSC 6.7 25290.1(h), None ❑ 25290.2(g), 25291(o, 25292(e), Yes 2636(0 (2) 2030026 Line leak detectors detect a 3 gph leak and/or RD audible and visual alarm ❑ ❑ ❑ ❑ ❑ None ❑ function properly - 23 CCR 16 2636(0(6), Yes 2666(c) 2030027 Turbine shuts down when a leak is detected or RD when line leak detector is ❑ ❑ H ❑ ❑ ❑ None ❑ disconnected - 23 CCR 16 Yes 2666(c) 2030025 Pressurized piping able to detect a 3.0 gph leak RD within an hour, and ❑ 1�o El ❑ None ❑ restricts the flow or Yes alarms - 23 CCR 16 2636(1) (2) Secondary Containment 2060010 UST storing a hazardous RD substance has secondary L ❑ ❑ ❑ ❑ None ❑ containment - HSC 6.7 14 Yes 25292 Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement %I- 0 4) SOC Comments No I— D Co 0 I'D = tv Z 0 Z M 0 W > 2030008 UDC, sumps, and/or other secondary containment in good ❑ ❑ r-1 F-1 ❑ 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 ❑ F� Fj n None ❑ liquid to drain into sump - Yes 23 CCR 16 2630(d), 2641(a 2060006 Secondary containment piping slopes back to the Fj ❑ ❑ 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 F-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 ❑ ❑ ❑ ❑ F-1 None ❑ remove liquid - 23 CCR 16 Yes 2635(b), 2665 2030054 Spill bucket maintained in RP good condition and free of ❑ ❑ F� 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 r-1 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 %I- 0 0 0 SOC Comments No 0 �> I-- CO) 0 �h-. = z 0 z M 0 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 ❑ ❑ r-1 ❑ ❑ 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 - E� El ❑ ❑ ❑ ❑ 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 1:1 1:1 ❑ ❑ ❑ 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 ❑ ❑ ❑ F-1 F-1 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), 2715(o Underground Storage Tank Program - DW Inspection Report v 2.0 Violation Program Requirement d ,o SOC Comments No o ¢ o o a 03o z O z v W o> 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. MThis report shall serve as a "NOTICE TO COMPLY" for Minor Violations, and a "NOTICE OF VIOLATION" for ajor 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: 'f -7 -- l y Inspector: Enter # of Violations: RD: ,_-,7 RP: Ca 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) U 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 (St /ZT naa) S60ZC14 '7////6 dl LNO:) "' :,®# 3NOHd '9 34N f ANt/dWfla4NI1S31 ANVdNO:) ONIIS31 )INVI QCXD'11"� n-4)�ol I p I ti I i I SiN31NO3 3wniOn # )INVi ON ❑ S3A ❑ �a31S31 99 Ol JNIOJ JNIdId SI :(131S31 39 01 S)1Ndl 30 # -T # 31"3dO 011IW213d 3WVN 'dOIV'i3dO 3WVN 2i3NM0 0`3 SMONd le 4MVR9 a 1 " � 71I d3 NOIIVN,HOdNI 31IS NOI1d0I- AU'd90 JNI801INOW l3f13 SS3N1HJIl NNd1 [� 1N3WNIVJ -NO3 A2iVaN033S 686-95 n 9NUS3l 3NI-1` NOIi0313a NV3l a3ONVHN3 A' o # IIMd3d (- Aj5uopaoz)3e asaz adAz azejedas .aad peBse o) aq oj0 m pue sad Ienpimpul aZe .sedan a e asaLIZ zeLp ajou asealdj N zi :)x:&xjL 3:) s umu -i3n:o 3o j 262d (INV ISAI SS�NIH9I I >INVI/9NIIS�1 IN3WNIVIN09 XdVdN09�IS 68695 '[LZZ-Z58-I99 :xed ®6L6£- 9Z£ -T99 :auoqd /9NIIS9I 3NI 3 W'dO421:qd 0 V 'Pagsa me g X0££6 _ OI1d3Ilddt �l fi4aaaS H T T Z SWMAJOS uoIjuanaad 1N3W121�id3Q 321I� ®13I�S2l3�lV/9 S�fNV►1 39"O1S ®Ni142lJii� ®N!1 31da 1 AS 03noaddd (13AOliddV lIWM3d V S3WO:)39 N0IlV3IlddV S! 1 rN3H r 31va 32ff11dNDI 1NV31lddb a0H13W 1S31 # 331 _ _ ` a31flf1aN fl 39 011S31 3WRj�, I1 '8 311fa oft 3I1213fl e.- 6 W VN 7, Ji,,vw , `� S�Baad 9 dl LNO:) "' :,®# 3NOHd '9 34N f ANt/dWfla4NI1S31 ANVdNO:) ONIIS31 )INVI QCXD'11"� n-4)�ol I p I ti I i I SiN31NO3 3wniOn # )INVi ON ❑ S3A ❑ �a31S31 99 Ol JNIOJ JNIdId SI :(131S31 39 01 S)1Ndl 30 # -T # 31"3dO 011IW213d 3WVN 'dOIV'i3dO 3WVN 2i3NM0 0`3 SMONd le 4MVR9 a 1 " � 71I d3 NOIIVN,HOdNI 31IS NOI1d0I- AU'd90 JNI801INOW l3f13 SS3N1HJIl NNd1 [� 1N3WNIVJ -NO3 A2iVaN033S 686-95 n 9NUS3l 3NI-1` NOIi0313a NV3l a3ONVHN3 A' o # IIMd3d (- Aj5uopaoz)3e asaz adAz azejedas .aad peBse o) aq oj0 m pue sad Ienpimpul aZe .sedan a e asaLIZ zeLp ajou asealdj N zi :)x:&xjL 3:) s umu -i3n:o 3o j 262d (INV ISAI SS�NIH9I I >INVI/9NIIS�1 IN3WNIVIN09 XdVdN09�IS 68695 '[LZZ-Z58-I99 :xed ®6L6£- 9Z£ -T99 :auoqd /9NIIS9I 3NI 3 W'dO421:qd 0 V 'Pagsa me g X0££6 _ OI1d3Ilddt �l fi4aaaS H T T Z SWMAJOS uoIjuanaad 1N3W121�id3Q 321I� ®13I�S2l3�lV/9 S�fNV►1 39"O1S ®Ni142lJii� ®N!1