HomeMy WebLinkAboutFMC Report 2013HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
3 /aCk9c'10%O
File Number: '3616 Address:
Date Received: ;-- 4 — 13
Business Name:
Bakersfield, CA 933
C(4,_Qvvto^j
SYSTEM: BUILDING SQUARE FEET:
New Mod.
Commercial Hood System
Fire Alarm System
Building Sq. Feet:
Calculation Bldg. Sq. Ft:
Fire Sprinkler System
Spray Finish System
Aboveground Storage Tank
Underground Storage Tank
minor
modification Underground Storage Tank
removal Underground Storage Tank
M,-' Other. `e ieS7-"' /
Comments:
P
0
4.
INSPECTION LOG
Date Time
011 ffi
71WAVIr
Sigrikure
Signature
i
r BAKERSFIELD FIRE DEPARTMENT
UNIFIED PROGRAM INSPECTION CHECKLIST rA I D Prevention Services Division
2101 H Street
I ! - Bakersfield, CA 93301
Underground Storage Tank Program Phone: 661- 326 -3979
Fax: 661 - 852 -2171
Facility Name: I Date of Inspection:
Rosedale Chevron Time In: I Time Out:
Address: 11 Inspected by: Esther Duran
9700 Rosedale Hwy. Bakersfield, CA. 93312 ICC# 5296325 -UI
Contact: Type of Inspection:
Annual Compliance Re- inspection Complaint
Nirmal Gill
Phone: Permission for Inspection Granted by:
6611588 -4455
Tank ID 1 2 3
Size 12,000 12,000 12,000
Contents Reg. Prem. DSL
Construction DWF DWF DWF
Tank Monitoring:
DW: Continuous Interstitial Monitoring
0 D Brine/Hydrostatic Vacuum /Pressure.
t7&
SW: 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.
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 Auto-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. 1 1
and Safety Code, the California Code of Requlations and the Code of Federal Requlations 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.
R6quir6ments:
Significant Operational Compliance
RD -Release Detection RP =Release Prevention
o
C
g
1 o
m
H z COMMENTS
Q File Review
1 UST Permit to Operate is current. HSC 25284(a), 25299(a)(1) 25299 (6)(1)
2 Transfer of permit and /or change of information provided within
30 days of ownership /information changes. HSC 25284(b) (c); T23
CCR 2712(d)
3 UST form information current/correct for facility, including BOE
number. HSC25286(a)
4 Fees are paid up-to-date. HSC 25285(c), 25287 PAI s
W Monitoring Plan approved for current owner with appropriate
content and level of detail. T23 CCR 2632(d), 2634 (d), 2641(h)
F6 Current Emergency Response Plan submitted with appropriate
content and level of detail. T23 CCR 2632(d), 2634 (d), 2641(h)
7 Plot Plan /Site Map submitted with appropriate content and
level of detail. T23 CCR 2632(d), 2634(d), 2641(h), 2711(a)(8)
8 Owner/Operator agreement submitted, if required. HSC 25284(a)(3)
k9 Certification of Compliance and Designated Operator
Certification submitted by current tank owner. T23 CCR 2715
10 Certificate of Financial Responsibility submitted and is current
for the permit period. HSC 25292.2, 25299.30 - 25299.34; T23 CCR 2711; 2808.1;
2809 - 2809.2
11 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
2 Spill- bucket test results (most recent) conducted within hi3
allowable time frame. Results submitted and indicate a passing
test. HSC 25284.2
13 Leak Detector testing conducted within allowable time frame. 21_13ThemostrecentannualcertificationsubmittedandshowsRDRDRDRD
passing results. 40 CFR 280.40(8)(2), 280.43(g)(1) &(2), 280.44(a); HSC 25292(e);
T23 CCR 2638, 2641
014 Secondary containment testing conducted within allowable
time frame. Most recent testing results submitted and indicate
a passing test. HSC 25284.1(a)(4)(B); 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 26360,
2643(b)(3), (c)(3), d e
016 Repaired tanks /piping are tightness tested within 30 days of RD RD RD RDtherepair. 40 CFR 280.33; T23 CCR 2661
17 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 RPI
adequate. Impressed current inspected every 60- calendar
days. 40 CFR 280.31, 280.70; T23 CCR 2635(x)(2)
019 Tank Lining recertification is current (within 10 years of lining
and every 5 years thereafter) and compliant. 40 CFR280.21(n)(1)(rr,); RP RP RP RPT23CCR2663(h)
I L
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979
UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT
Facility Name: Date:
Re uir ®manta: , Y 7.
Slgnlflcant Operatlon_al Compliance` AV
a
C
Q
11to Wb
Q
ZRD =Release Detection RP =Release Preyentlon r a' a. COMMENTS
D On -Site Review
This Inspection is being conducted during the annual
monitoring certification. OYES o NO
The service technician has provided ICC Certification and
manufacturers training documentation, and possesses a tank
tester's license or works under a CSL8 contractor's license.
L7 YES 0 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 & 2671
025 Overfill Prevention mechanism present and operational
according to type: Flapper valve Audible - visual alarm RP RP RP RP O
ball float. AN alarm and Ball Float 40 CFR 280.20(c)(1)Qi),
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)
Areas around vents appear to be free from signs of liquid
releases. HSC 25288(a), 25290.1, 25290.2, 25295.5
F02
Release Detection methods are present and meet performance RD RDstandards. See LG -113. 40 CFR 280.40(x)(3) RD RD
All sensors are correct for the type of system and operational. RD RD RD RD rr-1
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 s FS w crVi
r'°6s F° 1280.40(a)(2), 280.43(8)(1) &(2); HSC 25290.1, 25290.2, 25291; T23 CCR 2630(d); RD RD RD RD no1- -n t+,f ProPe
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
36 Interstitial monitoring conducted properly. 40 CFR 280.40(a)(2), RD RD RD RD El280.43 1 8 2' T23 CCR 2632 (c)(22; 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. 40 CFR
280.41, 280.43; T23 CCR 2643, 2646.1 RD RD RD RD
037 Non - passing SIR monitoring report results are reported and
investigated properly. 40 CFR 280.41(8), 280.43(h)(1),(2); T23 CCR 2646.1 RD RD RD R
Bakersfield Fire Department— Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979
UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT
0%,11ILY 1V QI 1 IG. LJQ
R9GUlr®rn®nt3! a:, r
gIN
G.
Slgnlficant0p _emtlonalCompllance`; L 9R3 =Release Detection RP =Release Prevention r ' g + H • Zi g r;< t counni.EiuT$
via
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
P9 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 b 1
O Manual Tank Gauging SW tanks </ =1000 gal. ONLY
040 Weekly manual tank gauging performed properly. 40 CFR 280.43; RD RD RD RD
T23 CCR 2645
041 Tank Integrity test performed, if necessary. 40 CFR 280.43; T23 CCR RD RD RD RD2645
O Vadose Zone and/or Groundwater Monitoring
42 Monitoring system is installed and monitored properly. 40CFR RD RD RD RD280.43 T23 CCR 2647 -48
OTank Exemption
043 Tanks /piping meet tank exemption criteria, and weekly visual
monitoring records are kept up-do-date. HsC 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)
45 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 RD
detected and the monitoring system shuts down the pump or
flow restriction occurs when a leak is detected in the UDC. T23
CCR 26360(5)
O Line Leak Detectors (LLD)
48 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)
050 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. 40CFR RD RD RD RD
280.41, 280.44; T23 CCR 2643(c)(2),(3)
1152 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
Facility Name:
UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT
Date:
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979
Req irernents• ..,:
Slgnlflca Operetlonal Comp lance
r.: __
o
C
M
fA
G
m
aRelease Detec on RP Re ease Preve on JCOMENTSVV
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 -D
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
57 LLD's installed, annually tested, and operational on SW
emergency generator systems; LLD is connected to an AN l
alarm. 40 CFR 280.40(8)(2), 280.43(g)(1),(2), 280.44(a); T23 CCR 2666
Corrosion Protection
058 Metal Tanks and piping components have corrosion protection,
or are isolated from the backfill. 40 CFR 280.20, 280.21 RP RP RP RP
059 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 RP
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(x)(2)
On -site Paperwork
062 Permit and conditions available on -site. Facility is operated e rw Gilr
according t0 permit and conditions. HSC 25293; 25299; T23 CCR 2712(1) n -
063 Monitoring and response plans are on -site and are the
approved version. T23 CCR 2712(i); 2632;2634; 2641
064 Site plan depicts current site conditions and has all required
elements. T23 CCR 2632(d)
065 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
066 All monitoring /testing records /documents are available for the
required timeframe. (3 years, 6 % years, five years, life of tank) T23 CCR
2712
67 Equipment maintenance records/logs available. T23 CCR 2712(b) O
068 Alarm logs /tapes available and appropriate follow -up actions
Occurred. T23 CCR 2712(6); 2632; 2634
069 Visual observation logs available, up -to -date, and appropriate
follow-up actions t0 problems occurred. T23 CCR 2712(b); 2642
070 Designated UST Operator monthly reports available and
complete. T23 CCR 2715
071 Employee training records available and training appropriate
and up-to-date. T23 CCR 2715
072 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
073 Financial Responsibility Certificate and mechanisms (CFO
Letter, etc.) on -site and up -to -date. HsC 25292.2, 25299.30 - 25299.34; T23
CCR 2711; T23 2808.1; 2809 - 2809.2
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979
14 UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT
Fability Name: Date:
SOC AND RED TAG
Req remen W
wens
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.
RedTa Re ortin Information for Report, 6
Slgnifl t Opera o a Compliance
RWRe ease Detectlo RP Releaae Prevention
C
A Red Tag was issued to this facility based on the results of this inspection.
Red Tag #
i m Z
1. Violation that causes or threatens to cause a liquid release. ccR 2717(a)(1)
V V CO ME TS
On -Site Observation ofPeriodic Testing
4 Spill- bucket testing conducted appropriately and a passing test
achieved.
075 Secondary Containment testing conducted appropriately and a
passing test achieved.
SOC AND RED TAG
Item Inspection Comments:
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979
C rack n data Aso. R® 0it 1I' f6r6 tlonN for Re ort'6 - Choose one) wens
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.
RedTa Re ortin Information for Report, 6 Yes
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. ccR 2717(a)(1)
2. Violation that impairs the ability of an UST system to detect a leak. ccR 2717(x)(2)
3. Chronic violation or committed by a recalcitrant violator. ccR 2717(x)(3)
Item Inspection Comments:
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business.Plan and Inventory Program
B_ E R S F I D
FIRE .
ARTM r
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
ch
COMMENTS
ADDRESS PHONE NO. NO OF EMPLOYEES
Rose s CA
FACILITY CONTACT 9 Z BUSINESS ID NUMBER
G i /1 O ,4
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
V= Violation
COMMENTS
APPROPRIATE PERMIT ON HAND BMC: 1.65.080)
BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY CBC:401)
VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
VERIFICATION OF QUANTITIES CCR: 2729.4)
VERIFICATION OF LOCATION CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL CCR: 2704.1)
VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(8))
VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR: 2731 ))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
CONTAINERS PROPERLY LABELED CCR: 66262.34(F), CFC 2703.5)
HOUSEKEEPING CFC: 304.1)
FIRE PROTECTION CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? YES NO Signature ofReceipt
Explain:
POST INSPECTION INSTRUCTIONS:
Refer to the back ofthis inspection report for regulatory citations and corrective actions
Correct the violation(s) noted above by
Within 5 days of correcting all. of the violations, sign and return a copy ofthis page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Signature (that all violations have been corrected as noted)
Date
White —Business Copy Yellow— Business Copy to be Sent in after return to Compliance Pink Prevention Services Copy FD2155 (Rev 12/11)
BAKERSFIELD FIRE DEPT..
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST OARTAI L D
214T H Street,
Bakersfield, CA-933011
S E CT 10 N 'I ::. Busin@SS Plan and, Inventory Program Tel.:_ (661) 326 -3979
Fax: (661) 85272171
FACILITY NAME INSPECTION DATE INSPECTION TIME
ADDRESS.. ; _ - _ PHONE NO. NO OF EMPLOYEES
9900 3, p-,
APPROPRIATE PERMIT ON HAND . BMC: 1.65.080)
FACILITY CONTACT 935/ Z BUSINESS ID NUMBER
01 BUSINESS PLAN-CONTACT INFORMATION ACCURATE.
Consent to Inspect Narne/Title
Section 1: Business Plan and Inventory 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)
01 BUSINESS PLAN-CONTACT INFORMATION ACCURATE. CCR: 2729.1)
VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY CBC: 401)
VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
VERIFICATION OF QUANTITIES CCR: 2729.4)
VERIFICATION OF LOCATION CCR:'2729.2)
PROPER SEGREGATION OF MATERIAL CCR:.2704.1)
VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(8))
VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF' ABATEMENT SUPPLIES AND PROCEDURES (CCR: 2731))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
CONTAINERS PROPERLY LABELED CCR: 66262.34(F), CFC 2703.5)
HOUSEKEEPING - , CFC: 304.1)
FIRE. PROTECTION CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS•WASTE ON SITE? YES NO SipnatureofReceiat.
Explain:
POST INSPECTION INSTRUCTIONS:
Refer to the back of this inspection report for regulatory citations and corrective actions
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 Street, California 93301.
White _ Business Copy - Yellow— Business Copy to he Sent in after return to Compliance .
Signature (that all violations have been corrected as noted)
Date
Pink Prevention' Services Copy FD2155 (Rev 12/11)
r,
i 1 4
f.
UNIFIED. PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
H C R S F 1 . 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
ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT G 3 3 Z BUSINESS ID NUMBER
91,01-4
Consent to Inspect Name /Title
Section 1: Business Plan and Inventory 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)
BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY CBC: 401)
VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
VERIFICATION OF QUANTITIES CCR: 2729.4)
VERIFICATION OF LOCATION CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL CCR: 2704.1)
VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(8))
VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES CCR: 2731))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
CONTAINERS PROPERLY LABELED CCR: 66262.34(F), CFC 2703.5)
1 HOUSEKEEPING CFC: 304.1)
FIRE PROTECTION CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? YES NO Signature of Receipt
Explain:
PON1 INSPEC77ON INSTRUCTIONS:
Refer to the back of this inspection report for regulatory citations and corrective actions
Correct the violation(s) noted above by Signature (that all violations have been corrected as noted)
Within 5 days ofcorrecting 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 Copy to he Sent in after return to Compliance Pink Prevention Services Copy FD2155 (Rev 12/11)
BAKERSFIELD FIRE DEPARTMENT
UNIFIED PROGRAM INSPECTION CHECKLIST B E R s F I LD
Prevention Services Division
FIRE
2101 H Street
ARTM T Bakersfield, CA 93301
Underground Storage Tank Program 440W Phone: 661- 326 -3979
Fax: 661 - 852 -2171
NOTICE TO COMPLY / SUMMARY OF VIOLATIONS
MINOR VIOLATIONS
Owner/Operator:
Facility:
Address:
There were NO violations observed during this inspection.
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-inspection may occur to determine compliance status.
SUMMARY OF VIOLATIONS
Item VIOLATION REQUIREMENT FOR CORRECTION OF DATE FOR
VIOLATION CORRECTION
Inspectors
Signature: 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 #&146
UNIFIED PROGRAM INSPECTION CHECKLIST
Underground Storage Tank Program
BAKERSFIELD FIRE DEPARTMENT
Prevention Services Division
B F R s F —n 2101'H StreetF /RE Bakersfield, CA 93301ARTMT
Fax: 661 -
85226 -
3979
Fax: 661 - 852 -2171
NOTICE TO COMPLY / SUMMARY OF VIOLATIONS
MINOR VIOLATIONS
Owner/Operator:
Facility:
Address:
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
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-inspection may occur to determine compliance status.
SUMMARY OF VIOLATIONS
Item REQUIREMENT FOR CORRECTION OF DATE FORVIOLATIONVIOLATIONCORRECTION
Inspectors
Signature: 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:
White — Business Copy Yellow — Business Copy to be sent in after Return-to-Compliance Pink — Prevention Services Copy
d-
UNIFIED PROGRAM INSPECTION CHECKLIST
Underground Storage Tank Program
BAKERSFIELD FIRE DEPARTMENT
Prevention Services Division
B F RE ' n 2101 H Street
AjrI r Bakersfield, CA 93301
Fax: 661-852-2171
661-326-3979
Fax:661- 852 -2171
NOTICE TO COMPLY / SUMMARY OF VIOLATIONS
MINOR VIOLATIONS
Owner/Operator:
Facility:
Address:
There were NO violations observed during this inspection.
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-inspection may occur to determine compliance status.
SUMMARY OF VIOLATIONS
Item VIOLATION REQUIREMENT FOR CORRECTION OF DATE FOR
VIOLATION CORRECTION
r
Inspectors
Signature: 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
BILLING- & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT
Prevention Services
PE WIT # Ite 2101 H StreetwRSr
Bakersfield, CA 93301
Dhnna• 491- 17A -147Q • FaY- AA1 -RS7 -2171
All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK.
i'
I.Alarm New & Modification (minimum charge)
SITE INFORtIATION
LOCATION OF PROJECT PROPERTY OWNER
Rosedale Chevron Same
STARTING DATE COMPLETION DATE NAME
PR03ECr NAME ADDRESS PHONE #
PRaIECTaDDaESS
9700 Rosedale Ht.vy. CITY R5f:lGI.-.A STATE Cat ZIPCODE
Underground Storage Tank (installation/Inspection) NI
CONTRACTOR INFORMATION
Over 10,000 sq ft 0.028 x sq ft
CONTRACTOR NAME Advanced Compliance CA LICENSE t
971259
TYPE OF LICENSE EXPIRATION DATE
C61 D40 3/31/2014
PHONE #
661- 706 -4321
CONTRACTOR COMPANY NAME FAX #
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.
i'
I.Alarm New & Modification (minimum charge) 280
82
Over 10,000 sq ft 0.028 x sq ft
82
Sprinkler - New & Modification (minimum charge) 280
82
Underground Storage Tank (installation/Inspection) NI
Over 10,000 sq ft 0.028 x sq ft
Underground Storage Tank (Modification) MOD 878 /site
Minor Sprinkler Modification ( <10 heads) 96 (inspection only)
Underground Storage Tank (Minor Modification) MTM
84
Commercial Hood (New & Modification) 470
573/tank 84
Additional hood S8
82
Spray Booth (New & Modification) 470
82
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
Underground Storage Tank (Minor Modification) MTM 167 /site 82
Underground Storage Tank (Removal) TR 573/tank 84
N Mandated Leak Detection (best) /Fuel Mont Cert/S8989
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 /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 Ins ctlon 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? _ 961hr 84 .
Explosive Storage 266 84
Copying & File Research (File Research fee $50 /hr) 0.25 /page 84
0 Miscellaneous I R4
BILLING & PERMIT STATEMENT ' BAKERSFIELD FIRE DEPARTMENT
Prevention Services
PEAUT # F1RM 2101 H StreetARrr
Bakersfield, CA 93301
Phnne: 661 -326 -3979 • Fax: _661 -RS2 -2171
X 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
96Mr (2 hrs minimum)=s1vz
SITE INFORMATION
Oil well (Installation, Inspection, or re- Inspection) X 96 /hr
LOCATION OF PROJECT PROPERTY OWNER
Tent #
Rosedale Chevron Same
STARTING DATE COMPLETION DATE NAME
PROJECT NAME ADDRESS
96 /hr + (5 hrs min standby fee /insp) =$576
5 hrs min stand! fee ins = 605
PRONE #
PROJECT ADDRESS
9700 Rosedale Hwy. CITY FAA V GRISTrI FLD STATE CA ZIP CODE
CONTRACTOR INFORMATION
Portable LPG (Propane): # of Cages? _
CONTRACTOR NAME Advanced Compliance 971259 TYPE
C61 D40 3%31%2014 P " oN.661- 706 -4321
CONTRACTOR COMPANY NAME
266
FAX S
Advanced Compliance 661- 589 -9329
ADDRESS CITaI ZIP CODE
3704 Littlefalls Ct. Bakersfield 93312
All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. '
PERMITTYPE FEE CALCULATION TOTAL TREASU
rjDUEACCTNis
Alarm - New & Modification (minimum charge) 280
n..oir in nnn en ft an ma v en ft
X 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
96Mr (2 hrs minimum)=s1vz o
Oil well (Installation, Inspection, or re- Inspection) X 96 /hr 82
Tent # 96 /tent 84
After -hours Inspection fee 121/hr (2 hrs minlmum) =$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? _ 96 /hr 84 ..
Explosive Storage 266 84
Copying & File Research (File Research fee $50 /hr) 0.25 /page 84
Miscellaneous 84
UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
SB989 SECONDARY CONTAINMENT TESTING
TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT N0.
ENHANCED LEAK DETECTION
TANK TIGHTNESS TEST
B 8 P D
w /RI
ARM fqw
BAKERSFIELD FIRE DEPT.
Prevention Services
1501 Truxtun Ave., 1s' Floor
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
Page 1 of 1
LINE TESTING SB-989 SECONDARY CONTAINMENT TESTING
X TO PERFORM FUEL MONITORING CERTIFICATION Cathodic Protection Testing
FD 2095 (Rev. 09/05)
SITE INFORMATION.
FACILITY psQpt%a C C y et/H NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 017U0 )QOS41 %,- hL" • 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 6 TIME TEST TO BE CONDUCTED Icc #: 8032698
SIGNATURE OF APP CANT . DATE 2/412013
APPROVED BY DATE
FD 2095 (Rev. 09/05)
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
AUTHORIZATION FOR FUEL
ELECTRICAL SEAK -OFF
TANKTESTING --
G j Ie i
OCCUPANCY TYPE:
OWNER: p 0, 1.
Y v1 C-
CONTRACTOR: A,, c 4wL a PHONE # 766-f32,1
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 IJST.AND /OR AST- SYSTEMS SHALL BE
lNSTALL,_COMPLETE AND ACCEPTED BY
MISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT.-
r- FIRE-DEPARTMENT (FINAL) -
REMARKS:
BUILDING ADDRESS: 76 O 777=7
JOB DESCRIPTION: L iiv P ;o - ,—FLA/tC OCCUPANCY TYPE:
OWNER: p 0, 1. PERMIT NO. -/
CONTRACTOR: A,, c 4wL a PHONE # 766-f32,1
FD 1743