HomeMy WebLinkAboutinspection report 2017BAKERSFIELD FIRE DEPARTMENT
Prevention Services Division
2101 H Street
Bakersfield, CA 93301
Phone: 661 -326 -3979
Fax: 661- 852 -2171
Underground Storage Tank - Double Wall Components PAGE 1 OF
Date: 9/06/2017 717acility
No: 15- 021 -68589
Inspection Type:
® 01 Routine ❑ 03 Re- inspection
❑ 04 Complaint ❑ Other
Facility Name: ARCO 82454- CAL000301810
Address: 2800 Panama Ln
Inspector: Shane Gardner
Cert. No:
Designated Operator:
Cert. No:
Service Tech:
Manufacturer Cert No:
Cert. No:
Service Contractor Company:
License Class & No:
Monitoring Console Manufacturer: Veeder Root
Monitoring Console Model No.: TLS 300
Consent To Inspect Granted By:
Name:
Title:
Tank ID
Tank ID
Tank ID
Tank ID
1
2
3
4
Contents
Contents
Contents
Contents
REG
REG
REG
PRM
Install Date
Install Date
Install Date
Install Date
1990
1990
1990
1990
Size
Size
Size
Size
10000
10000
10000
10000
Listed citations are to the Califomia Health and Safety Code HSC and California Code of Regulations CCR
No Violation Observed 2 Out of Compliance 3 Not Applicable 4 Undetermined 5 Corrected On Site 6 Re eat Violation 7 Violation Degree 8 Significant Operational Compliance
Violation No.
Facility Tank Information
NVO'
OUT'
NA'
UD4
COS5
RPT6
Degree'
SOC8
Comments
2030021
Facility has a valid Permit to Operate from the CUPA
- HSC 6.7 25284
❑
❑
❑
❑
❑
Complete and accurate UST Operating Permit
Application has been submitted - 23 CCR 16 2711;
HSC 6.7 25284, 25286
�
F]
F-1
❑
El
El
2010013
Facility has an approved Monitoring Plan - 23 CCR 16
2632(d)(1), 2634(d), 2641(h)
❑
❑
❑ I
❑
❑
2010014
Facility has an approved UST Response Plan - 23
CCR 16 2632(d)(2), 2634(e), 2641(h)
❑ I
❑
❑ 1
❑
❑
2030041
A complete and accurate plot plan has been updated
and submitted - 23 CCR 16 2632(d)(1)(C), 2641(h),
2711(a) (8)
❑
❑
❑
❑
❑
2010006
Owner /Operator has not made false statements,
certifications, or representations on any required
document - HSC 6.7 25299
❑
❑
❑
❑
❑
2010003
Owner /Operator has a DO and /or informed the CUPA
of any change(s) within 30 days - 23 CCR 16 2715(x)
❑
❑
❑
1 ❑
❑
Violation No.
Testing
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2030002
Leak detection equipment tested by qualified service
technician annually - 23 CCR 16 2638(a) & (b), 26410),
2715(i)
❑
❑
❑
❑
❑
2030074
Annual Monitoring System Certification Form to the
CUPA within 30 days of completion of the test - 23
CCR 16 2638(d)
El
F-1
El
1:1
F-1
Underground Storage Tank - Double Wall Components
PAGE 2 OF
Violation No.
Testing
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2030048
Secondary containment testing conducted every 36
months in accordance with requirements - 23 CCR 16X
F�
F-1
F-1
El
El
2010009
Secondary containment test results submitted to the
CUPA within 30 days after the test - 23 CCR 16
F�
1-1
F-1
F-1
F�
2030055
Spill bucket tested annually - HSC 6.7 25284.2
F�
F-1
El
El
F-1
2030042
0.1 gph annual line test performed and passed for
pressurized piping without fail safe or shut down - 23
F1
F-1
�Z
F-1
F�
2010005
ELD testing results sent to the board and the CUPA
within 60 days of completion of the test - 23 CCR 16
F-1
F�
F-1
F-1
F
2030064
CUPA was notified within 48 hours prior to testing -
F-1
DIF]
F-1
F-1 1
2030068
Initial or triennial ELD testing conducted on UST
system 1000' of public well - 23 CCR 16 2640(e),
F�
M
F�
Violation No.
Install/Repair
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
-
2060001
As-built plans for new installations and/or with the
permit application have been submitted - 23 CCR 16
El
F-1
;Z
F]
F]
El
Violation No.
General Monitoring
NVO
OUT
NA
UD
I COS
RPT
Degree
SOC
comments
2030003
Leak detection system maintains continuous
monitoring that activates an audible and visual alarm
F
F�
El
F-1
F-1
2030016
The annular space of the tank is continuously
monitored and activates an audible and visual alarm -
F-1
El
F�
F�
2030017
DW pressurized piping is equipped with Fail Safe &
Positive Shut Down in lieu of annual line testing - 23
CCR 16 2636(0(5)
�Z
El
F-1
M
F�
F-1
2030018
Double-walled pressurized piping is continuously
monitored with a system that activates an audible r
and visual alarm or stops or the flow at the dispense
F-1
F�
F]
F�
El
F-1
2030043
Leak detection equipment properly installed,
calibrated, operated, and maintained - 23 CCR 16
2638(a), 26416)
M
F�
El
F-1
F-1
2060005
UST system constructed with a monitoring system
capable of detecting entry into secondary
containment - HSC 6.7 29291(b)
F-1
F71
El
F-1
F�
2060015
Leak detection equipment is located so that leak is
detected at the earliest possible opportunity - 23 CCR
Leak detection equipment has not been tampered
with or disabled - HSC 6.7 25299(a)(9)
F-1
F-1
F1
El
F-1
F-1
2030062
El
I F-1
M
El
F-1
2030075
System is in compliance with Emergency Generator
Fank system Line Leak Detector exemption -
I F-1
F�
I/
M
F-1
. 7
UndergroundGtoreQeTank - Dnub|eVVo|Cnmponenta
PAGE 3C>F
Violation No.
conditions - 23 CCR 16 2636(0(6)
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2060022
System constructed with a monitoring system
capable of detecting entry of hazardous substance or
water into secondary containment - HSC 6.7
F-1
F�
F-i
F-�
r-i
m
2060023
2030034 ]Tag/sticker
on affixed monitoring equipment being
certified, repaired, or replaced - 23 CCR 16 2638(o
El
El
I El
I El
I El
I F-1
I -A
I
Violation No.
VPH Monitoring
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2030065
Interstitial space of the UST is under constant VPH
monitoring - HSC 6.7 25290. I(e)
F-1
F-1
F-1
F-1
F-1
2060023
System constructed with a monitoring system
capable of detecting entry of hazardous substance
liquid/vapor phase, or water into secondary
F�
El
rFZ
Z
F�
El
F�
containment - HSC 6.7 25290. 1(d)
Violation No.
Line Leak Detector
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
LLD installed on pressurized piping system - 23 CCR
F-1
7
1:1
7
7
2030025
LLD on pressurized piping monitors at least hourly, is
able to detect a 3.0 gph leak, and restricts/shuts off
flow when leak detected - 23 CCR 16 2636(0(2)_
F-1
0
Violation No.
Secondary Containment
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
-
Secondary containment installed after July 1, 2003 is
2030040
Secondarily contained piping maintained to allow
liquid to flow into the sump in the event of a leak - 23
El
F-1
2030047
Secondary containment maintained tight and has
been confirmed by testing - HSC 6.7 25290. 1(c),
Spill bucket installed, is liquid tight, has 5 gal cap,
has functional drain valve or other means to remove
liquid, and is resistant to galvanic corrosion - 23 CCR
F
F-1
F�
7
F-1
F�
El
2060020
Violation No.
Overfill
UST system is operated to prevent unauthorized
release, including spills and overfills - HSC 6.7
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
F�
El
F�
F-1
F�
F-1
2030035
2030036
Overfill prevention system has not been overridden
and meets overfill requirements - 23 CCR 16
F�
El
F-1
F-1
F]
F-1
Violation No.
Certifications
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2010007
Submit/maintain current Certificate of Financial
Responsibility/mechanism of financial assurance - 23
CCR 16 2711; 23 CCR 18 2808.1, 2809-2809.2; HSC 6.7
ILJ
F�
F-1
El
F-1
F-1
25292.2; HSC 6.75 25299.30-25299.34
Positive statement of compatibility for UST �ystem
components submitted and/or maintained - 23 CCR 16
F -1
E:1
F
2030007
Underground Storage Tank - Double Wall Components
PAGE 4OF
Violation No.
Designated Operator
NVO
OUT
NA I
UD
COS
RPT
Degree
SOC
Comments
2010004
Copies of DO inspections for last 12 months
maintained - 23 CCR 16 2715(e)
El
F-I
F�
F-I
F-I
F-I
2030020
Unburied fuel piping visually inspected at least
monthly and log kept - HSC 6.7 25281.5(b)(3)
2030013
Designated operator properly conducted the monthly
inspection and the reports are complete and all
facility employees have been properly trained - 23
CCR 16 2715(c)
F -1
F-I
F-I
F1
F-I
Violation No.
Maintenance/Tests
NVO
2030012
At least one employee is present during operating
hours that has received DO training - 23 CCR 16
F-I
F-I
F�
El
F-I
2010012
UST records of monitoring, testing, repairing, and
closure maintained - HSC 6.7 25293
F�
7
2010015
List of employees trained by the DO properly
El
2010008
F-I
F-I
F�
F-I
Violation No.
Logs
Records of monitoring and maintenance (e.g. alarm
logs) and appropriate follow-up actions are
maintained - 23 CCR 16 2632, 2634, 2712(b)
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2030001
El
F -1
F�
El
F-I
2030020
Unburied fuel piping visually inspected at least
monthly and log kept - HSC 6.7 25281.5(b)(3)
F�
F�
F�
FUD
F-I
F-I
F
Violation No.
Maintenance/Tests
NVO
OUT
NA
COS
RPT
Degree
SOC
Comments
2010012
UST records of monitoring, testing, repairing, and
closure maintained - HSC 6.7 25293
F�
7
El A
F�
El
2010008
Monitoring, maintenance, repairs, linings, and
upgrade records maintained for life of UST - 23 CCR
16 2712(b)
Permit Condition/Approval
F-I
F�
F-I
F-I
F-I
F-I
Violation No.
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2030078
Owner/Operator retained a copy of the permit to
operate at the facility - 23 CCR 16 2712(i)
UST Response Plan is available onsite - 23 CCR 16
F-I
F-I
F�
0
F�
2030046
2030033
UST Monitoring Plan maintained onsite - 23 CCR 16
Facility has a current written owner/operator
2030061
Any unauthorized release from the primary
containment recorded - HSC 6.7 25294
PEI
IE
2030039
Compliance with all operating permit requirements -
23 CCR 16 2712
F1
F1
1-1
7
7
2030059
LIST system below ground connected to a E Gen
system maintained in accordance with
exclusion/exemption status - HSC 6.7 25281.6(a)
Tank system located in below grade structure meets
exemption conditions - HSC 6.7 25283,5(a)
F]
E]
El
"E1
7
F]
El
El
I
YZ
2030076
2030014
-the
Owner/Operator received approval and has
implemented a training program at an unstaffed
facility - 23 CCR 16 2715(0(2)
F�
F1
El
I F-I
F-I
2030015
Facility exhibited that the methods used to monitor
the UST system meets the standards in 2643(f) - 23
El
El
F-I
Underground Storage Tank - Double Wall Components
PAGE 5 OF
2030073
Facility has corrected cited violations within 30 days
of receiving report - 23 CCR 16 2712(0
❑
❑
NA
❑
F❑
El
Degree
SOC
Comments
2030066
2030077
Owner /Operator notified /prepared report upon
discovery of unauthorized release - 23 CCR 16
2650(e), 2652; HSC 6.7 25295(x)(1)
El
'�a
❑
El
❑
1
❑1
2060027
Violation No.
Red Tag
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2030045
Red Tag information is legible and has not been
removed or tampered with - 23 CCR 16 2717.1(g)
❑
❑
❑
❑
❑
❑
2030044
Facility did not deposit or allow a deposit of
petroleum into a UST that has a red tag affixed to the
fill pipe - 23 CCR 16 2717.10
❑
❑ J21
❑
❑
❑
❑
Violation No.
Tank Closure
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2030063
Facility is in compliance with temporary closure
requirements - 23 CCR 16 2630(d), 2643(1), 2644.1(x)(2)
El
F-1
❑
1:1
El
F-1
F-1
❑
F-1
2030038
UST system properly closed and complies with
permanent closure requirements - 23 CCR 16 2670,
2672; HSC 6.7 25298
El
❑
❑
❑
F-1
Violation No.
Install /Repair
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2030066
Repaired and retested the system due to a failed
ELD test when located within 1,000' of public well -
HSC 6.7 25292.4(d), 25292.5(c)
❑
❑
❑
❑
❑
2060027
Tank system primary containment is constructed,
operated, and maintained product -tight - 23 CCR 16
2631(a); HSC 6.7 25290.1(c)(1), 25290.2(c)(1), 25291(x)(1)
❑
❑
❑
❑
❑
2060024
UST system is made of or lined with materials that
are compatible with the substance stored - 23 CCR 16
2631.1, 2660(m); HSC 6.7 25290.1(c)(1), 25290.2(c)(1),
25291(x)(1)
❑
❑
❑
❑
❑
2060021
Striker plate installed and positioned correctly - 23
CCR 16 2631(c), 2662(d)
❑
❑
❑
❑
❑
2060007
Primary and secondary containment designed and
constructed to an engineering specification - 23 CCR
162631(b), 2631(d)
xZ
El
❑
❑
F-1
❑
Corrosion protection installed for USTs and /or
cathodic protection system meets the consensus
standards - 23 CCR 16 2635(a)(2)(A), 2662(c)(1)(8)
Enhanced leak detection testing performed before
the tank is placed in use - HSC 6.7 25290.16)
❑
El
F-1
❑
F-1
F-1
2060008
❑
❑
❑
❑
❑
Violation No.
General Facility Requirements
NVO
OUT
NA
UD
COS
RPT
Degree
SOC
Comments
2010
Administration /Documentation - General - 23 CCR 16
Multiple; HSC 6.7 Multiple
❑
El
El
❑
El
Underground Storage Tank - Double Wall Components
Owner /0 erator: x ` /-,/-/
r r�
Facility: r c �z v,5— q
Address: - ► P A x14 L-"-, -
SUMMARY OF VIOLATIONS
Item
#
Notice Of Violatio Class.- 114ndlor Class I Violations were found during this inspection as
noted in the following Summa 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
CORRECThIrfN
j
£a
Iectors
:. -- f
Received b -_
Fp—hone :. � �'� � r;.� � �,� -� �
Print Name:
Date:_
Date:
White - Business Copy Yellow — Business Copy to be sent in after Return -to- Compliance Pink — Prevention Services Copy
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
.�
ADDRESS
PHONE NO.
NO, OF EMPLOYEES
.
FACILITY CONTACT
B USINESS ID NUMBER
Consent to Inspect Name/Title
x„,r..c,.fs. s" x. 4 . ..
1pz . a ` ,, � , �, • , ..� r . , r lr ' r r?.N te . a .
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�arr . �a �t, ..uwr.,_> a ,s/ ,, �. e w.-. - . ....4 . . . (x txs hr. a.`,'3 E . a. t ,.,.:, � . ., .. all o- v.3 u. iri: o� . ..l�:,' 3.. a, r 4t..<,a,:i.:, . .:�; o. R. . na '>s h,. _.t ,i< a. N- v., : . ��, 6 a
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E anoted) Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Date
White Business Copy Yellow — Station Copy Fv00 Services FD2155 (Rev 8H14) „
❑ ROUTINE COMBINED. JOINTAGENCY MULTI- AGENCY El COMPLAINT 171 RE- INSPECTION
C V C=Gompliance OPERATION CERS
V= Violation; I,IIMinor Violation COMMENT
.r. <
-
APPROPRIATE PERMIT ON HAND 3010001
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) 1010008
IV VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
JA
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: 731(c))
EMERGENCY PROCED U RES 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 1 NO i natureof -Ri i
-
• E
Inpector..•
POST INSa i w< r:P, .EC T, .� ,.< I. O.`n .:sY.N , aI:'2�.«,3.s�.F•LN,��c,� S T,.R U.: <.,Ca �.�," .T,
I . . .., .� O.-;;s..,,� ._. .:.r N S,:
Correct the violation(s) noted above .,. . ,b„ n
y
Within 5 days of correcting all of the violations, a . ✓ r d r n s{ n i..n s.. g n +. an. ,d ✓ B �. . v swr.��..eJ i . � tE :., u�r.s :� . � n r k. .. . ., „ cHa . .. . .u, < �. w.�c, ._ e.o> .r pF :,:. . y . oPf . .th. ,.i r e c ,s . s .pa u
a,ac..g>.. �e to:
:
• E
Inpector..•
POST INSa i w< r:P, .EC T, .� ,.< I. O.`n .:sY.N , aI:'2�.«,3.s�.F•LN,��c,� S T,.R U.: <.,Ca �.�," .T,
I . . .., .� O.-;;s..,,� ._. .:.r N S,:
Correct the violation(s) noted above .,. . ,b„ n
y
Within 5 days of correcting all of the violations, a . ✓ r d r n s{ n i..n s.. g n +. an. ,d ✓ B �. . v swr.��..eJ i . � tE :., u�r.s :� . � n r k. .. . ., „ cHa . .. . .u, < �. w.�c, ._ e.o> .r pF :,:. . y . oPf . .th. ,.i r e c ,s . s .pa u
a,ac..g>.. �e to:
HAZARDOUS WA$TE Vii, BAKERSFIELD FIRE DEPARTMENT
„F
UNIFIED PROGRAM CONSOLIDATED FORMS Prevention Services
$ E R 3 F I D 2101 H Street
SMALL QUANTITY HAZARDOUS
PINE. Bakersfield, CA 93301
WASTE GENERATOR INSPECTION
I�1tT�` Phone: 661- 326 -3979 • Fax: 661- s52 -21 1
Facility Name: ' _ . Date: 4:1
Site Address: Time In: Time Out:
# t
Owner /Operator: Phone: EPA ID # c� 00O'SS ? i
Type of Inspection
0 Routine 0 Re- inspection/Follow -up 1 C rnbined Routine Inspection 0 Joint Inspection 0 Complaint 0 Focused 0 Other
ICONSENT TO INSPECT GRANTED BY (Name / Title): t 4 -
spection may involve obtaining photographs, review and copying of records, and determination of compliance w th hazardous waste handling requirements.
C
%.,Vl
, V
j 1dua.- Y - %,xaaa 19 11 V1 A►AAAAWA . •vawuvaa
HAZARDOUS WASTE REQUIREMENT
NIA
CERS
Violation #
COMMENTS
Recordkee in documentation. .
Generator has an EPA ID number ' ' [HSC 25143.131
3010002
Hazardous waste' determination made for all wastes
0 Analysis 'Generator Knowledge [CCR 66262.401
3030005
Contin e cy 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 (s) of manifest mailed to DTSC [CCR 66262.23(a)(4)]
1.
3010011
Bills of Lading/receipts available [CCR 66262.40(a)]
1
3010010
LDRs available and complete [CCR 66268.7(a)]
3030006
Onsite recycling reported using UPCF HSC 25143.10
3030001
Container /tank manartement
Containers are in good condition JCCR 66262.34(d)(2)]
Containers are closed except when adding/removing ( CCR66262.34(d )(2)
3030013
3030017
`
Satellite containers at or near poin t 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
y.
Tanks inspected daily CCR 66262.34 d 2 , 40CFR 265.2011
1,
3030027
One container per waste stream at satellite area CCR 66262.34 d 2
3030022
-:'Y
Exclude recyclable materials stored in accordance with local
ordinance/hazardous materials codes [HSC 25143.10]
301001.6
N7
Accu ulation Time Limits "
Waste is accumulated not more than 90/10/270 CCR 66262.34(d)]
3030010
Empty containers managed within one ear CCR 66262.34(d)]
1
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 . < 1 ton) [CCR66266.81(a)(3)]
3030002
Labeling/Marking
"
i
Containers are properly labeled [66262.34(f)]
3030007
Excluded recyclable materials marked properly [HSC 25143.9(a)]
[
3050005
Universal waste container properly labeled (CCR 66273.341
3030008
Used oil filters marked "drained used oil filters" CCR 66266.1301
1
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
3030007
Tank marked with "haz waste" , contents, start date (66262.34(f)]
3030007
'
Treatment Transport and Disposal/Other
Have ermit/authorizationto do treatment [HSC 25136.21
@
.3040003
Waste sent with authorized trans ort (gen. eligible) [CCR 66263.41]
1
3050001
Waste disposed of to authorized point/ party [HSC 25189.5(a)].
3050002
Failed to properly handle appliance wastes HSC 25212 a
Fire Protection [66262.34(d)(2)]
3030032
Print and sign in this b er-re 1p`f `fo this,areport. Signature does not imply agreement with findings only receipt of report.
INSPECTOR 'SN-S rte'
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