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3601 STOCKDALE HWY (9)
INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST BAKERSFIELD FIRE DEPT. Prevention Services H i E R 30 I d a 1501 Truxtun Avenue, 1 s, Floor P /R/ Bakersfield, CA 93301 ARrM T Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 of I FACILITY NAME: Section 2: Underground Storage Tank Program INSPECTION DATE: I?J" Routine Combined Joint Agency Multi- Agency C3 Complaint C3 Re-Inspection Type Tank SG.J C, J' Number of Tanks 3 Type of Monitoring Type of Piping 'w FX 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 6 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: (t1Crlor•4nr Duran 326 -3656 Questions regarding this inspection? Please call us at (661) 326 -3979 White — Prevention Services 6/ " - Business S06 Responsible Party Pink - Business Copy FD 2156 (Rev. 03/08) 4tz fy %, ..£. UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program B_g Ii R 3. F [F L D Dj fIRE ARrM 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 DME ADDRESS 3 &( 5T0CA'Q2 %C 7 S / C,f 9 330 PHONE 60 Fie-1- NO OF EMPLOYEES . FACILITY CONTACT BUSINESS ID NUMBER 015-0,21-003132- 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: 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) a VERIFICATION OF QUANTITIES CCR: 2729.4) VERIFICATION OF. LOCATION CCR: 2729.2) PROPER SEGREGATION OF MATERIAL CFC: 2704.1) dr VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) VERIFICATION OF HAZ MAT TRAINING CCR: 2732) VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) t EMERGENCY PROCEDURES ADEQUATE CCR: 2731) CONTAINERS PROPERLY LABELED (CCR: 66262.34(n, 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 INSPECT ION 1NS7 RUC:1'IONS: Correct the violation(s) noted above.by 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 0 0 0 mmm Signature (that all violations have been corrected as noted) Date 0 White — Business Copy siness Copy to be Sent in alter return to Compliance Pink — Prevention Services Copy FD2155 (Rev 6//10) u. .. v-?13 KERN BUSINESS FORMS - (661) 325 -5818 - X6013 BAKERSFIELD FIRE DEPT. Prevention Servicest _s_I? i 1._pUNIFIEDPROGRAMINSPECTIONCHECKLIST RE 210111 street Of rM r Bakersfield, CA 93301 SECTION 1: - Business Plan and Inventory Program ; Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME INSPECTION DATE _ INSPECTION TJME COMMENTS APPROPRIATE PERMIT ON HAND ADDRESS PHONE NO. t-7 NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER E]," s- h,2/- 3 s Z 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) 0` Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) E]," 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) J, PROPER SEGREGATION OF MATERIAL CFC: 2704.1) J VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) O'. VERIFICATION OF HAZ MAT TRAINING CCR: 2732) VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) 19 , ,, EMERGENCY PROCEDURES ADEQUATE CCR: 2731) Elk, 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: POST INSPECTION INSTRUCTIONS: Correct the violation(s) noted above by Within 5 days of correcting all ofthe violations, sign and return a copy of this page to: Bakersfield FiVe„_Pir e too» Seryces, 2101 1-1 Street, California 93301 b © a` i QQSe Signature (that all violations have been corrected as noted) Date 0 White — Business Copy ri 'o = siness Copy to be Sent in alter return to Compliance Pink — Prevention Services Copy FD2155 (Rev 6t110)