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Home My WebLink About1131 OAK STREET (10)UNIFIED PROGRAM INSPECTION CHECKLIST J R S r t R D7DAAq SECTION 1: Business Plan and Inventory Program C 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 ee7- COMMENTS co , ADDRESS PHONE NO, NO OF EMPLOYEES 0K 1-r i 6,w ) 3,241 ,02 FACILI TIA(CTT, Q BUSINESS ID NUMBER l l 672-1 - nb 1 &3 Consent to Inspect Name/Title V ) l_ 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: 15.65.080) Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) y 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 CFC: 2704.1) VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) VERIFICATION OF HAZ MAT TRAINING CCR: 2732) VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) 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 of Receipt Explain: Si2±/1^ -- OZ76 q, lt7 3 0 '7 L/l f :.J(y tea° 3o i0 so EZ _OS POST INSPECTION INSTRUCTIONS: f Correct the violation(s) noted above by Within 5 days ol'correcting all of the violations, sign and return a copy ol'this page to: Bakersfield Fire Dept., Prevention Services, 2101 1 -1 Street, California 93301 LNSjD T y ; cRNi 67 I"7 6:0:•iv2 White — Business Copy Yellow — Business Copy to be Sent in after return to Compliance Signature (that all violations have been corrected as noted) Date Pink — Prevention ScrvicLs Copy FD2155 (Rev 6//10) r Ao /ate KERN BUSINESS FORMS -(661) 325 -5818 -#6013 UNIFIED PROGRAM INSPECTION CHECKLIST B r R S F_- t, P/RE D ARTM SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME 1 c C= Compliance OPERATION V= Violation INSPECTION DATE INSPECTION TIME r APPROPRIATE PERMIT ON HAND iF /i a co a-, ADDRESS Business PLAN CONTACT INFORMATION ACCURATE PHONE NO. NO OF EMPLOYEES I l 3 1 VISIBLE ADDRESS 329 -7 40 FACILI] Y C TACT CORRECT OCCUPANCY BUSINESS ID NUMBER C) O/5-- 02-1- 001,5 3 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: 15.65.080) 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 CFC: 2704.1) VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) VERIFICATION OF HAZ MAT TRAINING CCR: 2732) VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) EMERGENCY PROCEDURES ADEQUATE CCR: 2731) CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), -CFC: 2703.5) HOUSEKEEPING CFC: 304.1) X FIRE PROTECTION CFC: 903 & 906) SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) ANY HAZARDOUS WASTE ON SITE? .YES NO Signature of Receipt Explain: s;rzx1.7 !:;LTe -1112-1,, 3 o,9041 6k" P s 'Z r . T& 3c, z/ ,' // :;LS S - a z 2 s o,e 2.v ;- . POST INSPECTION INSTRUCTIONS: ' Correct the violation(s) noted above by e Within 5 days of correcting all ofthe violations, sign and return a copy of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 ta y o v; "1EOf z White — Business Copy Yellow — Business Copy to be Sent in aRer return to Compliance Signature (that all violations have been corrected as noted) Date Pink — Prevention Services Copy 1`132155 (Rev 6//10) J ChEv2av FACILITY NAME: 11 57- 3a ,e s Crti g 3301-1 Section 2: Underground Storage Tanks Program BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 of 1 INSPECTION DATE: 10///// Routine < Combined Joint Agency Multi- Agency Complaint Re- Inspection Type of Tank ()1,JC Number of Tanks l Type of Monitoring Type of Piping 1 cJ F OPERATION C V COMMENTS Proper tank data on file Proper owner / operator data on file x Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes X No Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding /labeling Is tank used to dispense MVF ?) If yes, does tank have overfill / overspill protection? C = Compliance V = Violation Y = Yes N = No Inspector: Questions regarding this inspection? Please call us at (661) 326 -3979 White — Prevention Services Business Ste Respon ' 4Pa Pink - Business Copy KBF -7335 FD 2156 (Rev. 09/05)