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2 OAK STREET (7)
CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES DIVISION 1501 TRUXTUN AVENUE x( 661) 326 -3979 Location: 2 0,4 r— s; . You are hereby required to take the following action at the above location; XCORRECT & CALL FOR REINSPECTION CORRECT & PROCEED 7 Completion Date for Corrections: Received by: Inspector: ErnieMedina Initial: Date: % 124> 1 /0 Desk Phone: (661) 326 -3682 (from 8 :00am to 8 :30am) CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT iPREVENTION SERVICES DIVISION 1501. TRUXTUN AVENUE 661) 326 -39/ 79 Location: 1L You are hereby required to take the following action at the above-location; OCORRECT & CALL FOR REINSPECTION CORRECT & PROCEED 3 ) I ?,-,' t-7,- LAF / tlt-, /7-,' -, 4,,,.;,/ C I -rl - /,?.:? C. /1'_5 Completion Date for'Corrections: Received by: Inspector Ernie Medina Initial: Date: Desk Phone: (661) 326 -3682 (from 8:00am to 8:30am) UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program B q ' E R S F 1 9) D j\ FIRE D ARrN BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME OAK n lJA44JA/ r/ INSPE6_TION DATE INSPECTION TIME 1(X a,-7 ADDRESS s C,4 PHONE NO. a3o/ NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER T_C»r2 Consent to In ect Name /Title VISIBLE ADDRESS on lLl_Qi` — ' AAQ Ao_ [ 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: 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) IJ9. VERIFICATION OF LOCATION CCR: 2729.2) PROPER SEGREGATION OF MATERIAL CFC: 2704.1) K VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) r °'-) St' A VERIFICATION OF HAZ MAT TRAINING CCR: 2732) VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) Ga! a4glt EMERGENCY PROCEDURES ADEQUATE CCR: 2731) CONTAINERS PROPERLY LABELED CCR: 66262.34(f), CFC: 2703.5) HOUSEKEEPING CFC: 304.1) FIRE PROTECTION CFC: 903 & 906) A SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) 91v 5/F ANY HAZARDOUS WASTE ON SITE? YES NO Si atur ofRecei t Explain: POST INSPECTION INSTRUCTIONS: Correct the violation(s) noted above by Within 5 days orcorrecting all of the violations, sign and return a copy orthis page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 1NS tGTEG® r y c ;q Lbr f White — Business Copy Yellow — Business Copy to be Sent in after return toCompliance v u Signature (that all violations have been corrected as noted) Date Pink — Prevention Services Copy FD2155 (Rev 6/110) KERN BUSINESS FORMS - (661) 325 -5818 -#6013 UNIFIED PROGRAM INSPECTION CHECKLIST N r 5 (' j It FIRE SECTION 1: Business Plan and Inventory Program 0q& 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 ADDRESS S 2s C 33 PHONE NO. a 3n1 NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER J 0 11A) %- Business PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1) Consent to Inspect Namne /Title O 41 '5tH I - 1.it11ri(' t 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: 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) g. VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) iVb % aN Sl 94 VERIFICATION OF HAZ MAT TRAINING CCR: 2732) VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES CCR: 2731(c)) G F L EMERGENCY PROCEDURES ADEQUATE CCR: 2731), CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5) HOUSEKEEPING CFC: 304.1) FIRE PROTECTION CFC: 903 & 906) I, SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) A-457' O/U 5W ANY HAZARDOUS WASTE ON SITE? YES - ENO Si nature ofRecei t Explain: MUST INSPECT ION 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 1 -1 Street, California 93301 1 NS FCT Sy , 'Q tJi & M © /Na White -- Business Copy , Yellow-. Business Copy to be Sent in alter return to Compliance r I OF Signature (that all violations have been corrected as noted) Date Pink — Prevention Services Copy FD21'55 (Rev 6 //10) FACILITY NAME: .2, 0A4 S"' 32/ec25 /r—/ CA 933 Section 2: Underground Storage Tanks Program Routine Combined Type o (Tank _ Type of Monitoring _ Joint Agency Multi- Agency Number of Tanks Type of Piping 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: '?,12-911-0 Complaint Re- Inspection OPERATION C V COMMENTS Proper tank data on file Proper owner / operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current X Failure to correct prior UST violations Has there been an unauthorized release? Yes 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: E?Wfi A/0.1rya Questions regarding this inspection? Please call us at (661) 326 -3979 White — Prevention Services Pink - Business Copy KBF -7335 FD 2156 (Rev. 09/05)