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Home My WebLink About6450 WHITE LANE FMC 2013HOODS ALARMS SPRINKLER SYSTEMS SPRAYAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. 131441Oa 13 File Number: %7 Z, Address: <'- 4! — 6 Bakersfield, CA 933 Date Received: Business Name: AV' C p SYSTEM: r BUILDING SQUARE FEET: INSPECTION LOG New Mod. Commercial Hood System Fire Alarm System Fire Sprinkler System Spvay Finish System Aboveground Storage Tank Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank C-- Other. Comments: i' ;: AA- . Building Sq. Feet: Calculation Bldg. Sq. Ft: 1. 2. 3. 4. Date Time Signature Signature BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work Inspection Request Phone No. (661) 326 -3979 UST NEW INSTALL DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS I AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF TANK TESTING UST REMOVAL DESCRIPTION DATE SIGNATURE AST NEW INSTALL DESCRIPTION DATE SIGNATURE MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE PRIOR TO:OPERATION OF ANY SYSTEM;, ALL UST AND /OR AST SYSTEMS SHALL BE INSTALL, COMPLETE AND ACCEPTED BY MISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT. FIRE DEPARTMENT (FINAL) BUILDING ADDRESS: 4 '( T- L-AJ JOB DESCRIPTION: OCCUPANCY TYPE: OWNER: C- p PERMIT NO. /3 -166 CC a/3 CONTRACTOR: 1J,,, c (i A,,jc PHONE # G FD 1743 Appendix VI Copies of Monitoring System Certification form and UST Monitoring Plot Plan available at http: //www.waterboards.ca.gov.) MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited. Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner /operator. The owner /operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: ARCO AMPM Bldg. Site Address: _ 6450 White Ln. City: Bakersfield Zip: Facility Contact Person: Contact Phone No.: Make/Model of Monitoring System: Veeder -Root TLS -350 Date of Testing)Servicing: _1_1_16 / 2013 B. Inventory of Equipment Tested /Certified Check the appropriate boxes to indicate specific equipment inspected/serviced: Tank ID: North 87 UL Tank ID: 91 UL X In -Tank Gauging Probe. Model: Mao. X In -Tank Gauging Probe. Model: Mao. X Annular Space or Vault Sensor. Model: 794390 -409 X Annular Space orVault Sensor. Model: 794390 -409 X Piping Sump / Trench Sensor(s). Model: 794380 -208 X Piping Sump / Trench Sensor(s). Model: 794380 -208 X Fill Sump Sensor(s). Model: 794380 -208 X Fill Sump Sensor(s). Model: 794380 -208 Li Mechanical Line Leak Detector. Model: u Mechanical Line Leak Detector. Model: X Electronic Line Leak Detector. Model: Series 8484 X Electronic Line Leak Detector. Model: Series 8484 0 Tank Overfill / High -Level Sensor. Model: Tank Overfill / High -Level Sensor. Model: 0 Other (specify equipment a and model in Section E on Page 2). Other (specify ui ment type and model in Section E on Page 2). Tank ID: South 87 UL Tank ID: X In -Tank Gauging Probe. Model: Man. 0 In -Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: 794390 -409 Annular Space or Vault Sensor. Model: X Piping Sump / Trench Sensor(s). Model: 794380 -208 Piping Sump / Trench Sensor(s). Model: X Fill Sump Sensor(s). Model: 794380 -208 0 Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: 0 Mechanical Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: Tank Overfill / High -Level Sensor. Model: 0 Other (sEeclU a ui ment a and model in Section E on Page 2). Other s eci ui ment type and model in Section E on Page 2). Dispenser ID: 1 -2 Dispenser ID: 7 -8 X Dispenser Containment Sensor(s). Model: 794380 -208 X Dispenser Containment Sensor(s). Model: 794380 -208 X Shear Valve(s). X Shear Valve(s). 0 Dispenser Containment Floats and Chain(s). Dispenser Containment Floats and Chain(s). Dispenser ID: 3 -4 Dispenser ID: 9 -10. 11 -12 X Dispenser Containment Sensor(s). Model: 794380 -208 X Dispenser Containment Sensor(s). Model: 794380 -208 X Shear Valve(s). X Shear Valve(s). 0 Dispenser Containment Floats and Chain(s). Dispenser Containment Floats and Chain(s). Dispenser ID: 5-6 Dispenser ID: 13 -14, 15 -16 X Dispenser Containment Sensor(s). Model: 794380 -208 X Dispenser Containment Sensor(s). Model: 794380 -208 X Shear Valve(s). X Shear Valve(s). 0 Dispenser Containment Floats and Chains 0 Dispenser Containment Floats and Chain(s). Ifthe facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification - I certify that the equipment identified in this document was Inspected/seryIced In accordance with the manufacturers' guidelines. Attached to this Certification is Information (e.g. manufacturers' checklists) necessary to verify that this Information Is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report; (check all that apply): X System set -up X Alarm history report I' ,- • Q Technician Name (print): Bruce W. Hinslev Signature: Certification No.: A25212 License. No.: 971259 Testing Company Name: Advanced Compliance Phone No.:(661) 706 -4321 Testing Company Address: 3707 Littlefalls Ct. Bakersfield, Ca. 93312 Date of TestinglServicing: 5 1 16 1 2013 Monitoring System Certification Page 1 of 4 12/07 2/21/07 D. Results of Testing /Servicing Software Version Installed: 131.00 Comolete the following checklist: X Yes No' Is the audible alarm operational? X Yes No' Is the visual alarm operational? X Yes u No` Were all sensors visually Inspected, functionally tested, and confirmed operational? X Yes No' Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes No' If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? X N/A X Yes No' For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system F1 N/A detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut -down? (Check all that apply) X Sumprrrench Sensors; X Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor failure /disconnection? X Yes; No. Yes No` For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no mechanical overfill prevention X N/A valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating property? If so, at what percent of tank capacity does the alarm trigger? % Yes' X No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. Yes' X No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) Product; Water. If es describe causes in Section E below. X Yes No' Was monitoring system set -up reviewed to ensure proper settings? Attach set up reports, if applicable X Yes No' Is all monitoring equipment operational per manufacturer's specifications? In Section E below, describe how and when these deficiencies were or will be corrected. Comments: Monitoring System Certification Page 2 of 4 12/07 2/21/07 F. in -Tank Gauging i SIR Equipment: X Check this box if tank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes No` Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes n No` Were all tank gauging probes visually inspected for damage and residue buildup? Yes 0 No` Was accuracy ofsystem product level readings tested? Yes 0 No' Was accuracy of system water level readings tested? Yes 0 No' Were all probes reinstalled properly? Yes 0 No' Were all items on the equipment manufacturer's maintenance checklist completed? In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Check this box if LLDs are not installed. Complete the following checklist: X Yes No` For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all N/A that apply) Simulated leak rate: X 3 g.p.h.; 0.1 g.p.h ; 0.2 g.p.h. Yes X No` Were all LLDs confirmed operational and accurate within regulatory requirements? X Yes No' Was the testing apparatus properly calibrated? Yes No' For mechanical LLDs, does the LLD restrict product flow if it detects a leak? X N/A X Yes No' For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A X Yes No" For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or 0 N/A disconnected? X Yes n No" For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or 0 N/A fails a test? X Yes No" For electronic LLDs, have all accessible wiring connections been visually inspected? 0 N/A X Yes No' Were all Items on the equipment manufacturer's maintenance checklist completed? In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: The 91 UL PLLD failed testing, It will be replaced. Monitoring System Certification Page 3 of 4 12107 2i21/O7 Advanced Compliance 3704 Littlefalls Ct. Bakersfield, Ca. 93308 661 - 706 -4321 Fax# 661 -589 -9329 VAPORLESS MANUFACTURING, INC. LDT -890 Leak Detector Test Record Contractor: Advanced Compliance Customer: ARCO AMPM Date: 5/16/2013 Location: 6450 White Ln. Bakersfield, Ca. Product: 87 UL Technician: Bruce W. Hinsle Submersible Pump Identification Manufacturer: FE Petro Model No.: Serial No.: Notes: Leak Detector Identification Manufacturer: Veeder -Root Description: PLLD Diaphragm-type: Piston-type: Tamper -proof seal installed: Other Style Leak Detector: Notes: Leak Detector in Submersible Pump Test at Dispenser Operating Pump Pressure (psi): 32 para. 15 Gallons per hour rate: 3.0 para. 22 Line pressure with pump shut off (psi): 20 para. 23 Bleed -back Test with pump off (ml): 150 para. 26 Step-through time to full flow (secs): N/A para. 30 Leak detector stays in leak search position (Yes/No): N/A para. 42 Leak Detector Test Pass / Fail Notes: Pass Complete thermal expansion test beforefailing leak detector Advanced Compliance 3704 Littlefalls Ct. Bakersfield, Ca. 93308 661- 706 -4321 Fax# 661 -589 -9329 VAPORLESS MANUFACTURING, INC. LDT -890 Leak Detector Test Record Contractor: Advanced Compliance Customer: ARCO AMPM Date: 5/16/2013 Location: 6450 White Ln. Bakersfield, Ca. Product: 91 UL Technician: Bruce W. Hinsle Submersible Pum p Identifcation Manufacturer: FE Petro Model No.: Serial No.: Notes: Leak Detector Identification Manufacturer: Veeder -Root Description: PLLD Diaphragm-type: Piston-type: Tamper -proof seal installed: Other Style Leak Detector: Notes: Leak Detector in Submersible Pump Test at Dispenser Operating Pump Pressure (psi): 28 para. 15 Gallons per hour rate: 3.0 ara. 22 Line pressure with pump shut off (psi): 19 ara. 23 Bleed -back Test with pump off (ml): 95 para. 26) Step-through time to full flow (secs): N/A para. 30 Leak detector stays in leak search position (Yes/No): N/A para. 42 Leak Detector Test Pass / Fail Notes: Fail Complete thermal expansion test beforefailing leak detector Advanced Compliance 3704 Littlefalls Ct. Bakersfield, Ca. 93308 661- 706 -4321 Fax# 661 -589 -9329 VAPORLESS MANUFACTURING, INC. LDT -890 Leak Detector Test Record Contractor: Advanced Compliance Customer: ARCO AMPM Date: 5/20/2013 Location: 6450 White Ln. Bakersfield, Ca. Product: 91 UL Technician: Bruce W. Hinsle NunmersiDie rum p wentnncatnon Manufacturer: FE Petro Model No.: Serial No.: Notes: Leak Detector Identification Manufacturer: Veeder -Root Description: PLLD Diaphragm-type: Piston-type: Tamper -proof seal installed: Other Style Leak Detector: Notes: Leak Detector in Submersible Pump Test at Dispenser Operating Pump Pressure (psi): 28 para. 15 Gallons per hour rate: 3.0 para. 22 Line pressure with pump shut off (psi): 19 para. 23 Bleed -back Test with pump off (ml): 95 para. 26 Step-through time to full flow (secs): N/A para. 30 Leak detector stays in leak search position (Yes/No): N/A para. 42 Leak Detector Test Pass / Fail Notes: Pass Complete thermal expansion test beforefailing leak detector SWRCB, January 2006 Spill Bucket Testing Report Form Thisform is intendedfor use by contractors performing annual testing of UST spill containment structures. The completedform and printoutsfrom tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: ARCO AMPM Date ofTesting: 5/16/2013 Facility Address: 6450 White Ln. Bakersfield, Ca. Facility Contact: Phone: Date Local Agency Was Notified ofTesting: 5/8/2013 Name of Local Agency Inspector (fpresent during testing): Ester Duran 2. TESTING CONTRACTOR INFORMATION Company Name: Advanced Compliance Technician Conducting Test: Bruce W. Hinsley Credentials: X CSLB Contractor ICC Service Tech. SWRCB Tank Tester Other (Specify) License Number(s): 971259 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic Vacuum Other Test Equipment Used: Visual Equipment Resolution: Identify Spill Bucket (By Tank Number, Stored Product, etc. 1 87 UL N. 2 87 UL S. 3 91 UL 4 Bucket Installation Type: Direct Bury X Contained in Sump Direct Bury X Contained in Sump Direct Bury X Contained in Sump Direct Bury Contained in Sum Bucket Diameter: 11" 11" 11" Bucket Depth: 11" 11" 11" Wait time between applying vacuum /water and start of test: 10 min. 10 min. 10 min. Test Start Time (Tj): 09:15 09:15 09:15 Initial Reading (R1): 9.50" 9.00" 09.00" Test End Time (TF): 10:15 10:15 10:15 Final Reading (RF): 9.50" 9.00" 09.00" Test Duration (TF — Tj): 1 Hr. 1 Hr. 1 Hr. Change in Reading (RF - Rj): 0.0" 0.0" 0.0" Pass/Fail Threshold or Criteria: 0.25" 0.25" 0.25" Test Result I X Pass Fail X Pass Fail X Pass Fail Pass Fail Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate, and infull compliance with legal requirements. Technician's Signature: Date: 5/16/2013 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. BILLING & PERMIT STATEMENT PERMIT # LIM f/R AR1Y BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 DMnno• . Fav fifi -ftS7 -7171 LOCATION OF PROJECT ARCO PROPERTY OWNER Same STARTING DATE COMPLETION DATE NAME PROJECT NAME ADDRESS PHONE # PRIOJECTADDRESS 6450 White Ln. CITY IgAWFR SFI ELX> sTATE OA ZIP CODE CONTRACTOR INFORMATION CONTRACTOR NAME CA LICENSE # Advanced Compliance 971259 TYPEOF LICENSE EXPIRATION DATE C61 D40 3/31/2014 PHONE # 661- 706 -4327 CONTRACTOR COMPANY NAME Advanced Compliance FAX t 661- 589 - 9329, ADDRESS 13704 Littlefalls Ct. CITY Bakersfield ZIP CODE 93312 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. DUE Alarm - New & Modification (minimum charge) $280 ONLY i ACCT NO! 0 Over 10,000 sq ft 0.028 x sq it Sprinkler - New & Modification (minimum charge) 280 Over 10,000 sq ft 0.028 x sq ft Minor Sprinkler Modlflcatlon ( <10 heads) 96 (inspection only) 64 Commercial Hood (Neal & Modification) 470 Additional hood 58 Spray Booth (New & Modification) 470 98 Aboveground Storage Tank (1 inspection per installation) AST 180 /tank 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 ( Modiflcatlon) MOD 878 /site 82 Underground Storage Tank (Minor Modification) MTM 167 /site 82 Underground Storage Tank (Removal) TR 573 /tank 84 11 Mandated Leak Detection (test) /Fuel Mont Cert/SS989 NOTE: $96 /hr for each type of test/per site even if scheduled at the same time TT 96 /hr (2 hrs minimum) $19 C' 4i k-c- l I GI Z 82 0 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 fns = 605 84 Re- Inspection /Follow -up Inspection 96 /hr 84 Portable LPG (Propane): # of Cages? a 96 /hr 84 Explosive Storage 266 84 Copying & File Research (File Research fee $50 /hr) 0.25 /page 84 Miscellaneous 84 FD 0021 (Ray 041101 THE FACE OF THIS DOCUMENT CONTAINS A Tvj6 TONED COLORED BACKGROUND WITH MICROPRINTING IN THE BORDER AND ORIGINAL DOCUMENT SECURITY SCREEN ON BACK WITH PADLOCKSCCURITY ICON. BILLING & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT Prevention Services PERMIT # R EF1rRe 2101 H StreetA Bakersfield, CA 93301 Phnnp- 661 -';26 -3979 • Fay- 661 -R52 -2171 SITE INFORMATION Alarm - New & Modification (minimum charge) LOCATION OF PROJECT PROPERTY OWNER Circle Deli Same STARTING DATE comPLEnoN DATE NAME PROIECT NAME ADDRESS PHONE 4 PROJMT ADDRESS 1416 Golden State crrY U CK Fi, —S ELD STATE CA ZIP CODE CONTRACTOR INFORMATION Over 10,000 sq ft CONTRACTOR NAME CA LICENSE tAdvancedCompliance971259 TYPE OF LICENSE EXPWrioN DATE C61 D40 3/31/2014 PHONE 661- 706 -4321 cONTRACTORCOMPANY NAME FAX S Advanced Compliance 661- 589 -9329 ADDRESS cITY ZIP CODE 3704 Littlefalls Ct. Bakersfield 93312 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. Alarm - New & Modification (minimum charge) 280 Over 10,000 sq ft 0.028 x sq ft Sprinkler - New & Modification (minimum charge) 280 Over 10,000 sq ft 0.028 x sq ft Minor Sprinkler Modification ( <10 heads) 96.Qnspectlon only) 84 Commercial Hood (Need & Modification) 470 Additional hood 58 Spray Booth (New & Modification) 470 98 Aboveground Storage Tank (1 Inspection per installation) AST 180 /tank 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 It Underground Storage Tank (Minor Modification) 167 to 3 Ck a0 f c Pc 2 Underground Storage Tank (Removal) TR 573/tank Mandated Leak Detection (test) /Fuel Mont Cert/SB989 NOTE: $96 /hr for each type of test/per site even if scheduled at the same time TT 96/hr (2 hrs mInimum)=$192 82 Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82 Tent # 96 /bent 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 stand fee Ins = 605 84 Re- Inspection /Follow -up Inspection 96 /hr 84 Portable LPG (Propane): # of Cages? i 96/hr 84 Explosive Storage 266 84 Copying & File Research (File Research fee $50 /hr) 0.25 /page 84 Miscellaneous 1 84 UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD / LINE TESTING SB989 SECONDARY CONTAINMENT TESTING TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION 4! FIRE ARM f BAKERSFIELD FIRE DEPT. Prevention Services 1501 Truxtun Ave., 181 Floor Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 of 1 PERMIT NO. ENHANCED LEAK DETECTION LINETESTING SB-989 SECONDARY CONTAINMENT TESTING TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION Cathodic Protection Testing FD 2095 (Rev. 09/05) SITE INFORMATION FACILITY ARCO NAME & PHONE NUMBER OF CONTACT PERSON ADDRESS 3125 California Ave. Bakersfield, Ca. OWNERS NAME Same OPERATORS NAME Same PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? YES NO TANK# VOLUME CONTENTS 1 87 UL 2 87 UL 3 91 UL TANK TESTING COMPANY, NAME OF TESTING COMPANY Advanced Compliance Bruce W. Hinsley 661- 706 -4321 MAILING ADDRESS 3704 Littlefalls Ct. Bakersfield, Ca. 93312 Bruce W. Hinsley 661- 706 -4321 CERTIFICATION #: A25212 DATE & TIME TEST TO BE CONDUCTED Icc #: 8032698 SIGNATURE OF APPLICANT DATE 43012013 APPROVED BY DATE FD 2095 (Rev. 09/05) UNIFIED PROGRAM INSPECTION CHECKLIST Underground Storage Tank Program BAKERSFIELD FIRE DEPARTMENT a F D Prevention Services Division PAR! 2101 H Streetirmir T Bakersfield, CA:93301 Phone: 661- 326 -3979 Fax: 661 - 852 -2171 Facility Name: Arco AM /PM #05420 Date of Inspection: Time In: Time Out: Address: 6450 White Ln. Bakersfield, CA. 93309 Inspected by: Esther Duran ICC# 5296325 -UI Contact: Edmond Nassar T e of Inspection: nnual Compliance Re- inspection Complaint Phone: 1(661)398-0393 Permission r Insp tion Gr ted Tank ID 1 2 3 Size 12,000 12,000 12,000 Contents REG. REG. PREM. Construction DWF DWF DWF Tank Monitoring: Q6L Continuous Interstitial Monitoring Brine/Hydrostatic E3 Vacuum/Pressure. El W: SIR and Line Test every 2 years. SW: ATG 0.1 annual. SW: ATG 0.2 monthly. SW: Continuous In -Tank Leak Detection (CITLD). SW: Tank Gauging. El E] SW: Vadose /GW Monitoring. Other Description: Piping Monitoring: DW Suction: Continuous Interstitial at UDC and Tank Sump. DW Pressurized: Interstitial at UDC and Turbine Sump and 3.0 gph LLD, Annual Line Test or uto-shutdown and Failsafe. DW VPH Monitoring: Includes lines, sumps, fill pipe, vapor lines, etc. SW Conventional Suction: Triennial 0.1 gph line test., and daily monitoring. SW Pressurized: Line 0.1 gph annual or 0.2 gph monthly line test and LLD with Auto-Shutdown. SW or DW Safe Suction. SW: Vadose Zone or GW Monitoring. DW or SW: Gravity Flow Pipe. Other Description: References to the Health and Safety Code, the California Code of Regulations and the Code of Federal Regulations throughout this Appendix are intended to be useful but are not necessarily exhaustive of all legal references that might apply or be relevant to a specific compliance determination. Laws and regulations are subject to change, so the references contained herein may not be up to date. It is the responsibility of the owner and operator to know and comply with all applicable legal requirements. UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT Facility Name: Date: Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 If In compliance, check the box. Check NA if not applicable. If a violation, determine If Minor, Class II, or Class I, or To ViolationsBeDetermined (TBD) if uncertain and will be determined later. Requirements: Significant Operational Compliance RD =Release Di tecilon. RP =Release Prevention C V m H Z COMMENTS D Fite Review 1 UST Permit to Operate is current. HSC 25284(a), 25299(a)(1) 25299 (b)(1) 2 Transfer of permit and /or change of information provided within 30 days of ownership /information changes. HSC 25284(6) (o); T23` CCR 2712(d) UST form information current/correct for facility, including BOE number. HSC 25286(a) 12k I Fees are paid up-to-date. HSC 25285(c), 25287 Monitoring Plan approved for current owner with appropriate content and level of detail. T23 CCR 2632(d), 2634 (d), 2641(h) Current Emergency Response Plan submitted with appropriate content and level of detail. T23 CCR 2632(d), 2634 (d), 2641(h) Plot Plan /Site Map submitted with appropriate content and level of detail. T23 CCR 2632(d), 2634(d), 2641(h), 2711(a)(8) Owner/operator agreement submitted, if required. HSC 25284(a)(3) 9 Certification of Compliance and Designated Operator D.O ertifcation submitted by current tank owner. T23 CCR 2715 Certificate of Financial Responsibility submitted and is current vie•,/ yo >'^ for the permit period. HSC 25292.2, 25299.30 - 25299.34; T23 CCR 2711; 2808.1; C'44jrx'. % c6AWAlC 2809- 2809.2 1 2 011 Monitoring system certification (most recent) conducted within allowable timeframe (sensors and console). Results submitted and show all required components with passing results. HSC 25284. 1 a 4 c ; T23 CCR 2638 012 Spill- bucket test results (most recent) conducted within allowable time frame. Results submitted and indicate a passing test. HSC 25284.2 013 Leak Detector testing conducted within allowable time frame. The most recent annual certification submitted and shows RD RD RD RD passing results. 40 CFR 280.40(x)(2), 280.43(9)(1)8(2), 280.44(a); HSC 25292(e); T23 CCR 2638, 26416) 4 Secondary containment testing conducted within allowable time frame. Most recent testing results submitted and indicate a passing test. HSC 25284. 1(a)(4)(8); T23 CCR 2637(a) 015 Pipe and /or tank integrity testing conducted within allowable time frame. Most recent testing results submitted and indicate passing results. 40 CFR 280.33, 280.40, 280.41, 280.44; T23 CCR 2636(0, 2643 b 3, (c)(3), d e 16 Repaired tanks /piping are tightness tested within 30 days of RD RD RD RDtherepair. 40 CFR 280.33; T23 CCR 2661 017 ELD test conducted within allowable time frame. Most recent test results submitted and passing results achieved. T23 CCR 2644.1 018 The corrosion protection system is checked by a corrosion specialist within six months of installation /repair and at least every three years thereafter; results show protection to be RP RP RP RP adequate. Impressed current inspected every 60- calendar days. 40 CFR 280.31, 280.70; T23 CCR 2635(a)(2) 019 Tank Lining recertification is current (within 10 years of lining and every 5 years thereafter) and compliant. 40 CFR280.21(b)(1)(ri,); RP RP RP RPT23CCR2663(h) Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT G4ni1i4%i Al -mmc• rh +o• 1 GVIIIL GIV• - VGV. Slgntflcant Ope tlonal 6ompllance + { fi arm,. r* RD = Release Deteon RP =Release Preventiction t COMMENTS 4 On -Site Review This Inspection is being conducted during the annual monitoring certification. OYES L7 NO The service technician has provided ICC Certification and manufacturers training documentation, and possesses a tank Enlp 2s -is tester's license or works under a CSLB contractor's license. O YES O NO Tank/Piping Components, Monitoring and Monitoring Equipment General 020 Tank systems meet current construction standards as required for type of system. HSC 25288 021 Hazardous substance tanks have secondary containment. 40 RP RP RP RP CFR 280.42(b); T23 CCR 2631 022 Electronic monitoring system has audible and visual alarm in operating condition. T23 CCR 2632, 2634, 2636 023 Monitor console programmed appropriately for monitoring option used. T23 CCR 2638, 2643, 2643.1 024 Tank systems in temporary closure meet requirements. 40 CFR RD RD RD RD280.70, T23 CCR 2670 8 2671 025 Overfill Prevention mechanism present and operational according to type: Flapper valve Audible- visual alarm RP RP RP RP ball float. AN alarm and Ball Float 40 CFR 280.20(c)(1)(i), 280.21 d ; T23 CCR 2635(b)(2), 2631 d 4 026 Spill prevention device is present and functional (in good condition and drain mechanism operational if applicable). 40CFR RP RP RP RP 280.20 c 1 1, 280.21(d) ; T23 CCR 2635(b)(1);2665 027 Piping and piping penetration boots within sumps /UDC are in good condition. HSC 25288(a), 25292.1 028 All sumps, spill buckets, and UDC's free from debris and liquid. HSC 25291(e), 25290.1, 25290.2; T23 CCR 2635(b)(1)(C) 029 Areas around vents appear to be free from signs of liquid releases. HSC 25288(a), 25290.1, 25290.2, 25295.5 030 Release Detection methods are present and meet performance RD RD RD RDstandards. See LG -113. 40 CFR 280.40(a)(3) 031 All sensors are correct for the type of system and operational. RD RD RD RD 40 CFR 280.40 a 2 , 280.43 1 & 2 ; HSC 25290. 1 e , 25290.2 25291; T23 CCR 2638 032 All sensors are located in the proper position /location. 40 CFR 280.40(a)(2), 280.43(8)(1)&(2); HSC 25290.1, 25290.2, 25291; T23 CCR 2630(d); RD RD RD RD El 2632(c);2641(a) 033 All secondary containment, including UDC shall be equipped with a continuous monitoring system that either activates an AN alarm or stops the flow of product at the dispenser when it detects a leak. T23 CCR 2636 (0(1) Tank Monitoring O DW Interstitial monitoring conducted properly. 40CFR280.40(a)(2), RD RD RD RD 280.43 1 8 2; T23 CCR 2632 (c)(2); 2634 d 1 035 VPH monitoring conducted properly. HSC 25290.1 RD RD RD RD O SW O SIR 036 SIR and Biennial 0.1 gph tank test performed properly. 40CFR RD RD RD RD280.43; T23 CCR 2643, 2646.1 u280. 41, 37 Non-passing SIR monitoring report results are reported and RD RD RD RDLinvestigatedproperly. 40 CFR 280.41(a), 280.43(h)(1),(2); T23 C.CR 2646.1 Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT F '1' N D t0%, 1 LY a11 Ie. a e. 85 4 3 Requirements: Slgnlflcant Operatlonal Compliance t, l•, 5Z F : COMp..MENTS h. ,; FwuA -.w ' qAC , I t"'c... e+ WW K, O Automatic Tank Gauging (ATG) / Continuous In -Tank Leak Detection CITLD 038 ATG or CITLD 0.2 gph monthly test performed properly. 40 CFR RD RD RD RD 280.43; T23 CCR 2643(b)(1), 2643 b 5 R39 ATG generates a hard copy printout of all data reported including time and date, tank I. D., fuel depth, water depth, temperature, liquid volume and duration of test. If installed after 1/1/95 printout includes calculated leak rate and leak threshold. T23 CCR 2643 6 1 O Manual Tank Gauging SW tanks </ =1000 gal. ONLY 1j40 Weekly manual tank gauging performed properly. 40 CFR 280.43; RD RD RD RDT23CCR2645 041 Tank Integrity test performed, if necessary. 40CFR280.43; T23 CCR RD RD RD RD2645 O Vadose Zone and /or Groundwater Monitoring 042 Monitoring system is installed and monitored properly. 40CFR RD RD RD RD 280.43; T23 CCR 2647 -48 OTank Exemption 43 Tanks /piping meet tank exemption criteria, and weekly visual monitoring records are kept up-do-date. r+sC 25283.5 Pipe Monitoring O DW O Continuous Monitoring System 044 DW piping (gravity, suction, pressure) in the turbine sump has continuous monitoring system that activates an audible and RD RD RD RD visual alarm or restricts or stops flow at dispenser. T23 CCR 2636 (0(1) 045 DW piping in the UDC is continuously monitored and method either shuts down the flow of product to the dispenser or activates an AN alarm. T23 CCR 26360(1) O Line Integrity Testing for Pressurized Piping 046 An annual 0.1 gph line integrity test is performed properly. Either third party or by Enhanced Line Leak Detection) T23 CCR RD RD RD RD 2636 (0(4) 047 In lieu of the annual tightness test for DW pressurized piping, the monitoring system for all product piping outside the dispenser is fail -safe and shuts down the pump when a leak is RD RD RD RDdetectedandthemonitoringsystemshutsdownthepumpor flow restriction occurs when a leak is detected in the UDC. T23 CCR 2636(0(5) O Line Leak Detectors (LLD) 048 LLD's installed, annually tested, and operational on DW pressurized piping that detects a 3.0 -gph leak, and restricts or RD RD RD RD shuts off flow of product. T23 CCR 2636(0(2) O DW Emergency Generator Tank 049 LLD activates AN alarm and monitoring system is checked RD RD RD RDdaily. T23 CCR 26360(2) 1150 In lieu of LLD, continuous monitoring system of DW emergency generator tank activates AN alarm, system is checked daily, and logs are kept. T23 CCR 2636 0(6) O SW O Line Integrity Testing 051 SW pressurized piping: annual 0.1 gph line integrity test or a monthly 0.2 gph line integrity test is performed properly. 40 CFR RD RD RD RD 280.41 280.44 T23 CCR 2643 c 2 , 3 52 SW conventional suction system: 0.1 gph line integrity test is RD RD RD RDperformedeverythreeyears. 40 CFR 280.40, 280.41; T23 CCR 2643(d) Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT Facility Name: Date: Req it ents: rum q7j, ZPrverrtlonVx E'lease 53 SW conventional suction system: inspections conducted for presence of air in the pipeline. Daily monitoring records are kept - T23 CCR 2643(d) 054 SW gravity flow piping: biennial 0.1 gph integrity test or overfill tank integrity test is conducted within allowable time frames. T23 CCR 2643(e) O Safe Suction (SS) System 055 Piping meets the SS requirements. 40 CFR 280.41; T23 CCR 2636(a)(3) RD RD RD RDa -a O LLD for Pressurized Piping 056 LLD's installed, annually tested and operational on SW pressurized piping. Pump shuts down when a leak occurs and RD RD RD RD when the LLD fails or is disconnected. T23 CCR 2666 057 LLD's installed, annually tested, and operational on SW emergency generator systems; LLD is connected to an AN i alarm. 40 CFR280.40(a)(2), 280.43(8)(1),(2), 280.44(a); T23 CCR 2666 Corrosion Protection 058 Metal Tanks and piping components have corrosion protection, RP RP RP RPorareisolatedfromthebackfll. 40 CFR 280.20, 280.21 59 Corrosion protection equipment turned on, functioning properly and provides continuous protection. 40 CFR 280.31(a),(b)(1); T23 CCR RP RP RP RP 2635 060 Cathodic protection system is tested within 6 months of installation and then every 3 years. 40 CFR 280.31(a) & (b)(1); T23 CCR RP RP RP RPT 2635 a 2 061 Impressed current systems checked every 60- calendar days RP RP RP RP and records are up-to-date. 40 CFR 280.31(c); T23 CCR 2635(a)(2) On -site Paperwork 62 Permit and conditions available on -site. Facility is operated according t0 permit and conditions. HSC 25293; 25299; T23 CCR 2712(1) 63 Monitoring and response plans are on -site and are the approved version. T23 CCR 2712(1); 2632;2634; 2641 64 Site plan depicts current site conditions and has all required elements. T23 CCR 2632(4) 65 All release detection records for monitoring method are available, up -to -date, and appropriate for leak detection RD RD RD RD method. 40 CFR 280.41, 280.45 66 All monitoring /testing records /documents are available for the required timeframe. (3 years, 6'/1 years, five years, life of tank) T23 CCR 2712 067 Equipment maintenance records/logs available. T23CCR2712(b) 168 Alarm logs /tapes available and appropriate follow -up actions occurred. T23 CCR 2712(b); 2632, 2634 069 Visual observation logs available, up -to -date, and appropriate follow-up actions t0 problems occurred. T23 CCR 2712(b); 2642 0 Designated UST Operator monthly reports available and complete. T23 CCR 2715 71 Employee training records available and training appropriate 1:1 1 and up-to-date. T23 CCR 2715 72 Suspected or actual unauthorized releases are recorded and /or reported within allowed timeframes, including non- RD RD RD RD passing test results. Leak and Spill Logs available. 40 CFR 280.50; T23 CCR, 2650, 2652 3 Financial Responsibility Certificate and mechanisms (CFO Letter, etc.) on -site and up -to -date. HSC 25292.2, 25299.30 - 25299.34; T23 3', ` 1CCR2711; T23 2808.1; 2809 - 2809.2 Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT Facility Name: Date: SOC AND RED TAG w'S,OC Re u fires a. This facility is in compliance with Release Detection (RD) requirements only. (No violations in boxes marked RD, but one or more in boxes marked RP. Slgnlfl Ope ona Com (lance D e ea De ect on RORelease Prevention C V V violations in boxes marked RP, but one or more in boxes marked RD. Z COMMON S c. This facility is in compliance with BOTH Release Detection (RD) and Release On -Site Observation of Periodic Testing Prevention RP requirements. No violations in boxes marked RD or RP. d. This facility is NOT in compliance with both Release Detection (RD) and Release 74 Spill- bucket testing conducted appropriately and a passing test achieved. and RP. Re .orti"n rinfo`rnatron for "R® ort'6 75 Secondary Containment testing conducted appropriately and a passing test achieved. A Red Tag was issued to this facility based on the results of this inspection. Red Tag # SOC AND RED TAG w'S,OC R 'ln`formation for'R® o`rt 6'Choosewone . Track in,database'- fires a. This facility is in compliance with Release Detection (RD) requirements only. (No violations in boxes marked RD, but one or more in boxes marked RP. b. This facility is in compliance with Release Prevention (RP) requirements only. (No violations in boxes marked RP, but one or more in boxes marked RD. c. This facility is in compliance with BOTH Release Detection (RD) and Release Prevention RP requirements. No violations in boxes marked RD or RP. d. This facility is NOT in compliance with both Release Detection (RD) and Release Prevention (RP) requirements. (One or more violations marked in (both) boxes RD and RP. R ®:d Ta Re .orti"n rinfo`rnatron for "R® ort'6 A Red Tag was issued to this facility based on the results of this inspection. Red Tag # Reason for Red Tag Choose one): 1. Violation that causes or threatens to cause a liquid release. CCR2717(a)(1) o 2. Violation that impairs the ability of an UST system to detect a leak. CCR 2717(a)(2) 3. Chronic violation or committed by a recalcitrant violator. CCR 2717(a)(3) Item Inspection Comments: Bakersfield Fire Department— Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 BAKERSFIELD FIRE DEPARTMENT. UNIFIED PROGRAM INSPECTION CHECKLIST rAR . , p Prevention Services Division r 2101 H Street T Bakersfield, CA 93301 Underground Storage Tank. Program Phone: 661- 326 -3979 Fax: 661-r85272171 NOTICE TO :COMPLY [SUMMARY OF VIOLATIONS MINOR VIOLATIONS Owner/Operator: Facility: Address:. There were NO violations observed during this inspection. Print Name: Date: S- Date: - 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 corrected in a , timely manner. This report does not represent: that there are no other violations at this facility. A re -insinspection may occur to determine compliance status. SUMMARY OF VIOLATIONS Item REQUIREMENT FOR CORRECTION OF DATE FORVIOLATIONVIOLATION' CORRECTION a s jC) n e alr Inspectors Q nature Received by: Si Phone: - Print Name: Date: S- Date: - CERTIFICATION OF RETURN TO COMPLIANCE I rtifythat the violations noted above on this Notice to Comply /Summary of Violations have been co rected. I have personally examined any documentation attached to the certification to establish that the,violations have been corrected. Signature: Title: Print Name: Date: . KPS 06446 White — Business Copy Yellow — Business Copy to be sent in. after Return -to- Compliance Pink — Prevention Services Copy UNIFIED PROGRAM INSPECTION CHECKLIST Underground Storage Tank Program B rBAKERSFIELD FIRE DEPARTMENT Prevention Services Divisionff1 2101 H Street Bakersfield, CA 93301T Fax: 661-852-2171 661-326-3979 Fax:661- 852 -2171 NOTICE TO COMPLY / SUMMARY OF VIOLATIONS MINOR VIOLATIONS Owner/Operator: Facili : A t\A Address: r -, LAj4 \-A 1 There were NO violations observed during this inspection. Date: 0 Notice to Comply: Minor Violations were found during this inspection as noted in the following Summaty 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 corrected in a timely manner. 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 REQUIREMENT FOR CORRECTION OF DATE FORVIOLATIONVIOLATIONCORRECTION 1 a l cr fes Gf SAP J -4 e V Inspectors Si nature: /, --- -- Received by: Phone: Print Name: Date: Date: CERTIFICATION OF RETURN TO COMPLIANCE I certify that the violations noted above on this Notice to Comply /Summary of Violations have been corrected. I have personally examined any documentation attached to the certification to establish that the violations have been corrected. Signature: Title: Print Name: Date: KPS #8446 White — Business Copy Yellow — Business Copy to be sent in after Return -to- Compliance Pink — Prevention Services Copy BAKERSFIELD FIRE DEPT. Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST B E R S r A U D 2101 HStreetFIRE ARtM r. Bakersfield, CA 93301 SECTION 1:. Business Plan and " Inventory Program Tel.: (661),326-_3.979;. Fax: (661)852 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME o APPROPRIATE PERMIT ON HAND ADDRESS PHONE NO. NO OF EMPLOYEES PLAN CONTACT INFORMATION ACCURATE 2 oBUSINESS ` — ` - ccJ O FACILITY CONTACT j BUSINESS ID NUMBER 2 Consent to Inspect Narneffitle Section.1: Business Plan-and Inveritory:.Program ROUTINE COMBINED JOINT AGENCY MULTI-'AGENCY " COMPLAINT RE- INSPECTION C v C= Compliance OPERATION V= Violation COMMENTS . APPROPRIATE PERMIT ON HAND BMC: 1.65.080) PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1) oBUSINESS ` — ` - ccJ O El. VISIBLE ADDRESS CFC: 505. 1, BMC; 15.52.020) CORRECT OCCUPANCY - CBC: 401) lr{ VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3) f. VERIFICATION OF QUANTITIES CCR: 2729.4.) VERIFICATION OF LOCATION . CCR: 2729.2) PROPER SEGREGATION OF MATERIAL CCR: 2764.1). VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(8)) VERIFICATION OF HAZ MAT TRAINING CCR: 2732) t VERIFICATION OF ABATEMENT' SUPPLIES AND PROCEDURES CCR: 2731)) EMERGENCY PROCEDURES ADEQUATE CCR: 2731) CONTAINERS PROPERLY LABELED CCR: 66262.34(F), CFC 2703.5) y- ._ HOUSEKEEPING CFC: 304.1) FIRE PROTECTION CFC: 903 & 906) F' , 6 V7 , + U SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) ANY'HAZARDOUS.WASTE ON SITE? DYES . NO Signature ofReceiyt Explain: t POST INSPECTION ]INSTRUCTIONS: Refer to the back ofthis inspection report for regulatory citations and corrective actions Correct the violation(s) noted above by Signature (that all violations have been.corrected a§ noted) 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 Date White — Business Copy - Yellow — Business Copyto be Sent in after return to Compliance:, Pink Prevention Services Copy FD2155 (Rev 12n 1) UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program R R R S F I D FIRE ARTM T BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME COMMENTS V= Violation ADDRESS NO. NO OF EMPLOYEES T PHONE V FACILITY CONTACT BUSINESS ID NUMBER CCR: 2729.1) k: DA4 ?f2 j t1 Consent to Inspect Name /Title Section 1: Business Plan and Inventory Program ROUTINE COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION C V c C= Compliance OPERATION COMMENTS V= Violation APPROPRIATE PERMIT ON HAND BMC: 1.65.080) BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1) 1 j t1 Ll` VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020) CORRECT OCCUPANCY CBC: 401) k VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3) VERIFICATION OF QUANTITIES CCR: 2729.4) VERIFICATION OF LOCATION CCR: 2729.2) X PROPER SEGREGATION OF MATERIAL CCR: 2704.1) VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(B)) VERIFICATION OF HAZ MAT TRAINING CCR: 2732) t VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES CCR: 2731)) EMERGENCY PROCEDURES ADEQUATE CCR: 2731) CONTAINERS PROPERLY LABELED CCR: 66262.34(F), CFC 2703.5) D HOUSEKEEPING CFC: 304.1) FIRE PROTECTION CFC: 903 & 906) SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) f ANY.-HAZARDOUS WASTE ON SITE? El YES NO Signature of Receipt Explain: PUNT INSPECTION INS "1'RUC'1'I0NS: Refer to the back of this inspection report for regulatory citations and corrective actions Correct the violation(s) noted above by Within 5 days ofcorrecting all ofthe violations, sign and return a copy of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 White —Business Copy Yellow— Business Copy to b° Sent in after return to Compliance Pink Prevention Services Copy Signature (that all violations have been corrected as noted) Date- FD2155 (Rev 12/11)