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3360 PANAMA LANE (7)
UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program B I E R S F_ IP_ L D FIRE ARrM r BAKERSFIELD FIRE DEPT, Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.:: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME / v c C= Compliance OPERATION V= Violation INSPECTION DATE 27- INSPECTION TIME 16: Q 0 ADDRESS APPROPRIATE PERMIT ON HAND PHONE NO. NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 615- OW — O/ 79, 2- Consent to Inspect Name /Title VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020) 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) XOf 11 HOUSEKEEPING CFC: 304.1) X/ FIRE PROTECTION CFC: 903 & 906) SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) NY HAZARDOUS WASTE ON SITE? YES NO Signature of'Receipt V Explain: POST' INSPECTION 1NS'PRUC "1`I0NS: e Correct the violation(s) noted above by - o Within 5 days of correcting all of the violations, sign and return a copy ofthis page to:. Bakersfield Firp D t. P e0vel O nn Services, 2101 H Street, California 93301 0 Signature (that all violations have been corrected as noted) Date W1dic — nosiness Copy °— Business Copy to be Sent in alter return to Compliance . Pink — prevention Services Copy FD2155 (Rev 6H10) 1 30 L..- .,.i:..,1.. ep ,+# CAP_Cv01?,33(61 KERN BUSINESS FORMS - (661) 325 -5818 - #6013 UNIFIED PROGRAM INSPECTION CHECKLIST B _ERs P 11 - FIRE SECTION 1: Business Plan and Inventory Program U I? 13 '78z BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME 7 INSPECTION DATE INSPECTION TIME COMMENTS r V= Violation ADDRESS PHONE NO. NO OF EMPLOYEES APPROPRIATE PERMIT ON HAND 0Y7 FACILITY CONTACT '73313 BUSINESS ID NUMBER Consent to Inspect Name /Title Section 1: Business Plan and Inventory Program ROUTINE '®., COMBINED JOINTAGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION C v C= Compliance OPERATION COMMENTS r V= Violation b APPROPRIATE PERMIT ON HAND BMC: 15.65.080) f 11. Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) j- 0 VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020) fl\ CORRECT OCCUPANCY CBC: 401) VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3) s VERIFICATION OF QUANTITIES CCR: 2729.4) LW` VERUFICATION OF LOCATION CCR: 2729.2) PROPER SEGREGATION OF MATERIAL CFC: 2704.1) 1147 J VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) VERIFICATION OF HAZ MAT TRAINING CCR: 2732) r y VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) Q EMERGENCY PROCEDURES ADEQUATE CCR: 2731) CONTAINERS PROPERLY LABELED CCR: 66262.34(f), CFC: 2703.5) Q HOUSEKEEPING CFC: 304.1) r' b FIRE PROTECTION CFC: 903 & 906) D. SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) ANY HAZARDOUS WASTE ON SITE? ©,YES NO Signature ofReccint iQ Explain: POST INSPECTION INSTRUCTIONS: Correct the violation(s) noted above by Within 5 days of correcting all orthe violations, sign and return a copy orthis page to: Bakersfield Fire e t ven"ti i lices, 2101 H Street, California 93301 Q o Whi1c - Business Copy e etl 1 - usiness Copy to be Sent in aflCr rettirn to Cooiplianee Signature (that all violations have been corrected as noted) Ucnc Pill# — Prevention Services Copy FD2155 (Rev 6//10) BAKERSFIELD FIRE DEPT. INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: 360 P /VaMa t v. INSPECTION DATE: t,3a mac' 3 13 Section 2: Underground Storage Tank Program Routine Combined Joint Agency Multi- Agency Complaint Re- Inspection Type of Tank iJi.J Number of Tanks —3 Type of Monitoring CLNI Type of Piping 126.>r' OPERATION Prevention Services S 1501 Truxtun Avenue, 1 s Floor p /R/ Bakersfield, CA 93301 A T Tel.: (661) 326 -3979 Proper owner / operator data on file Fax: (661) 852 -2171 Page I of 1 Routine Combined Joint Agency Multi- Agency Complaint Re- Inspection Type of Tank iJi.J Number of Tanks —3 Type of Monitoring CLNI Type of Piping 126.>r' OPERATION C V COMMENTS Proper tank data on file x Proper owner / operator data on file 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 No Section 3: Aboveground Storage Tank 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: I ctnir D fart 326 -3658 Questions regarding this inspection? Please call us at (661) 326 -3979 White — Prevention Services v M L 4 f Business SiteSite Respons rty Pink - Business Copy FD 2156 (Rev. 03/08)