HomeMy WebLinkAbout3500 stine rd rtc 2019ANIIIJ `' •'
CT I O N 1: Hazardous Materials Business Flan
InsDeetion
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
C V S h�r&-pcs,
INSIPECTIOP DATE
S 6
INSPECTION TIME
► o' 30
ADDRESS
PH NE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
Consent to Inspect Name/Title
Busy ess P anand I:Iriuellto Pro/uf 1':ram `k
r Section 1 n ,
❑ ROUTINE ❑ COMBINED ❑ JOINTAGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
lance
C �/ om p OPERATION
V =Violation; 1,11 Minor
C E R S
Violation
#
COMMENT
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
3010001
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008
i
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
1
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
i
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
V
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
SPr = -1KlPr yf 17ee is
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? A,,Y ES ❑ NO
kignature ofRecei't
Explain:
Inspector: J�� (o)6
POST INSP G°TION INSTRUCTIONS: _
• Correct the violation(s) noted above by
• Within 5 days of correcting all of the viola 'ons, Jfgn and return a copy of this 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 — Station Copy Pink—. Prevention Services FD2155 (Rev 8//14)
HAZARDOUS WASTE ���h'' �" SAKERSFIELD FIRE DEPARTMENT
UNIFIED PROGRAM CONSOLIDATED FORMS B E R S F I t D Prevention Services
M x ....._.. ........._. 2101 H' Street
SMALL QUANTITY (HAZARDOUS ' "�A'��
�,. �iRTA9 T Bakersfield, CA 93301
Phone: '661- 326 -3979 e Fax: 661- 852 -2171
WASTE GENERATOR INSPECTION
Facility Name: C ✓ S ,.,1 � q ' I
c. 7i� � Date: � f ` •% /
Site Address: 3 S�O o f -1 2 Time In: `. 3 C1 Time Out:
Owner /Operator: �j+e ✓e e� Phone: C,26 - �'z -9- g'�Gf EPA ID # a�? dt� Z G� s
Type of Inspection
0 Routine 0 Re- inspection/Follow -up 0 Combined Routine spection 0 Joint Inspection Complaint 0 Focused 0 Other
0 CONSENT TO INSPECT GRANTED BY (Name / Title):
Inspection may involve obtaining photographs, review and copying of re ords, and determination of compliance with' hazardous waste handling requirements.
C = Com laint: V = Class I,11 or Minor Violation
C
V
HAZARDOUS WASTE REQUIREMENT
N/A
CERS
Violation #
COMMENTS
Used oil filters marked "drained used oil filters" [CCR 66266.130]
Recordkee in documentation
3030004
Generator has an EPA ID number [HSC 25143.13]
Date written on s ent lead -acid batteries [CCR 66266.81(a)(6)(B)]
3010002
3030003
Hazardous waste determination made for all wastes
0 Analysis 0 Generator Knowledge [CCR 66262.40]
3030005
Contin ency laninformation osted near hone [CCR 66262.34(d)(2)]
3010022
Facility personnel demonstrate training /awareness [CCR 66262.34(d)(2)]
3020001
Manifests /Consolidated Manifest receipts complete [CCR 66262.23(a))
3010008
Blue co y(s) of manifest mailed to DTSC [CCR 66262.23(a)(4)]
3010011
Bills of Lading /recei is available [CCR 66262.40(a)]
3010010
LDRs available and corn lete [CCR 66268.7(a)]
3030006
Onsite rec clin re orted usin UPCF -[HSC 25143.10]
3030001
Container /tank mana a lent
Containers are in good condition [CCR 66262.34(d)(2)]
3030013
Containers are closed exce t when adding /removin [CCR66262.34(d)(2)]
3030017
Satellite containers at or near oint of eneration [CCR 66262.34(e)(1)(A)]
Em ty containers are em ty [CCR 66262.34(f)]
3030007
Containers ins ected weekl [CCR 66262.34(d)(2)]
3030019
1
Tanks ins ected dail [CCR 66262.34(d)(2), 40CFR 265.201]
3030027
One container er waste stream at satellite area [CCR 66262.34(d)(2)]
3030022
Exclude recyclable materials stored in accordance with local
ordinance /hazardous materials codes [HSC 25143.10]
3010016
Accumulation Time Limits
Waste is accumulated not more than 90/180/270 [CCR 66262.34(d)]
3030010
Em t containers mana ed within one ear [CCR 66262.34(d)]
3030010
Universal waste accumulated less than one year [CCR 66273.15(a)]
3030011
Used oil filters offsite within 180 (1 year <1 ton) [CCR 66266.130(c)(4)]
3030004
Pb -acid batteries offsite within 180 (1 yr. < 1 ton) [CCR66266.81(a)(3)]
3030002
Labeling/Marking
Containers are properly labeled [66262.34(f)]
3030007
Excluded recvclable materials marked nronerly (HSC 25143.9(a)l
3050005
"Used Uil" marked on all used oil tanks /containers LUCK 662.19.21(b)l 3UJ000/
Tank marked with "haz waste" , contents, start date [66262.34(f)] 3030007
Treatment, Transport and Disposal/Other
Have ermit/authorization to do treatment [HSC 25136.2] 3040003
Waste sent with authorized trans ort (en. eligible) [CCR 66263.41] 3050001
Waste dis osed of to authorized oint/ arty [HSC 25189.5(a)] 3050002
fled to ro ern handle a fiance wastes [HSC 25212(a)]
Fire Protection [66262.34(d)(2)] 3030032 j
Print and sign in tins box for receipt of this report. Signature does not imply agreement with findings only rece
INSPECTOR C. 6
T'�
POST INSPECTION INSTRUCTIONS:
• Correct the violations) noted above by
• Within 5 days of correcting all of the viola ions, sin and return a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H St. Bakersfield, CA 93301
White — Business Copy Yellow— Station Copy
of
in S Cc l;.cR,l
Signature (that all violations have been corrected as noted)
Date
FD2171 (Rev 9/14)
Pink - Prevention Services Copy
Universal waste container properly labeled (CCR 66273.34]
3030008
Used oil filters marked "drained used oil filters" [CCR 66266.130]
3030004
Date written on s ent lead -acid batteries [CCR 66266.81(a)(6)(B)]
3030003
"Used Uil" marked on all used oil tanks /containers LUCK 662.19.21(b)l 3UJ000/
Tank marked with "haz waste" , contents, start date [66262.34(f)] 3030007
Treatment, Transport and Disposal/Other
Have ermit/authorization to do treatment [HSC 25136.2] 3040003
Waste sent with authorized trans ort (en. eligible) [CCR 66263.41] 3050001
Waste dis osed of to authorized oint/ arty [HSC 25189.5(a)] 3050002
fled to ro ern handle a fiance wastes [HSC 25212(a)]
Fire Protection [66262.34(d)(2)] 3030032 j
Print and sign in tins box for receipt of this report. Signature does not imply agreement with findings only rece
INSPECTOR C. 6
T'�
POST INSPECTION INSTRUCTIONS:
• Correct the violations) noted above by
• Within 5 days of correcting all of the viola ions, sin and return a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H St. Bakersfield, CA 93301
White — Business Copy Yellow— Station Copy
of
in S Cc l;.cR,l
Signature (that all violations have been corrected as noted)
Date
FD2171 (Rev 9/14)
Pink - Prevention Services Copy
Name:
Address
City:
ZIP:
Contact:
Teleohoi
aPtC1�`1�1tf0 i�; ^ '
Occupancy /Use: le j ,,
772 /1 12 A Construction Type: V/
No. Stories:
Year Constructed: 41,uIe_
Aw, 11,
',
Contractor information:
Number of System Risers
Name: r'
P t�x....1+�Sr�,L=
Copy sent to:
Address: ,,2 ;s'', l �- ,.,1`.l w: ,.- .a,►.��.s
.+� ❑ Owner Date'.
City: {� - �-s. '� ,�.� ,� eS ew
❑ Fire AHJ Date;
State: o 2a ske 2 :2
❑ Contractor Date.
❑
El
NOTES:
Telephone: Z2 S �7 z22, 49 -"
p
1)'For specific inspection, testing, and maintenance
1:1
Q
requirements and information, see NFPA 26, 2011
CA License#: 220 I /
0
Edition as amended by California Code of Regulations,
r_..,
1:1
Title 19, §901 to §90
Job #:
0
®
1:1
u
2) Inspection, items may be performed by the owner in
Performed by: 1144A,,1,* � / %,,
0
accordance with California Code of Regulations, Title 19,
.�........,._„ ......r....._._
�,n!L/
_
§944.1(a)
eck.-b ox,for each system inspected and enter the ttumb6r of forms used far inspection
Ch" (Fail or mass} to lndic; tW status Qf ih$p #edE system af• cnd ' i,nspcoticrn:.
Z-Autornatic Sprinkler System
5
0,
Q Standpipe and Hose System
6
0
1:1
❑
El
0 Private Water Supply System
-- ----
7
p
El
1:1
Q
Fire Pump
$
0
Ll
1:1
0 Water Storage Tank
g
0
®
1:1
u
❑ Water Spray System
10
0
❑
(� Foam Water Sprinkler System
11
0
El
1:1
11
E Water gist System
12
0
Q
Q Concerns that are not deficiencies (i.e. Non- Sprinklered Areas)
❑ Yes
❑ No
*�e RQe�4C�e�� s��d VOrrirrt�nt.�" .Se�fCkr'l at Gr1Cf Q� +Ec7C�f r�spect�v� fC1rrT1,. .. ._
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1.1
I Control Valves -- Identification Sign
13.3,1
12
1 Control Valves - Inspection
13.3.2
1.3
1 Waterflow Alarm Devices
5.2.5
1.4
1 Supervisory Devices
5,2.5
1.5
1 Gauges (Wet Pipe Systems)
5.2.4.1
C
1.6
1 Hydraulic Design information Sign
(For hydraulically designed systems)
5.2.6
1.7
1 Enter Water Supply Pressure Below Riser Check
5.2.4.1
o psi
1.8
1 Enter Water Supply Pressure Above Riser Check
5.2.4.1
7 S --,psi
1.9
1 Pressure Readings Acceptable
5.2.4.1%
1 10
I General Information Sign
(not required for system prior to 2007 Edition NFPA 13)
5 2 8
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1.11
i Heat Tape
5.2.7
1.12
1 Spare Sprinklers
5.2.1.4
1.13
1 Fire Department Connections
13.7
'
'Eoc w• G� otxt r
1.14
I Alarm Valves - Exterior Inspection
13.4,1
1.15
1 Pressure Reducing Valves
13,5.1,1
1.16
1 Backflow Preventers
13.6.1
`"
I = Ins ection T =Test M = Maintenance P = Pass F = Fail AVA = Not Applicable
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5.1.6, 13.5.2
13.5.5.1
-,2
1.18
1
PRV - Fire Sprinkler Systems
13,5.1.1
/
1.19
1
Buildings (Freeze Protection)
4.1.1.1
Owner's Responsibility
� u�
1.20
B
Sprinklers
5.2.1
1.21
1
Sprinklers - Accessible Concealed Space
1.22
1
Pipe and Fittings
5.2.2
4
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1.23
1
Pipe and Fittings - Accessible Concealed SpacQ,-,
5.2.2.3
1.24
1
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5.2.3
1,25
1
Hangers - Accessible Concealed Space'
5.2.3,3
k
1.26
1
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5.2.3
1.27
1
Seismic Braces - Accessible Concealed. Space
5.2.3.3
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1.28
1
Unsprinklerecl:Areas
CFC 901.4
[]Yes No
21
T
Field Service Test Required
5 3 1
If REQUIRED, Enter'F' until
Send Report to Fire Code Official
results are returned from Lab
R3 1#4
2.2
'T
Recalled Sprinklers
Title 19
if not present= Pass; if present = Fail
904.1(c)
2.3
T
Water Flow Alarm Devices
90 secs max. Enter lime
5.3.3
13.2.6
--2 sec.
2 4
T
Main Drain Test
13.2,5
(Enter data on Page 9 of this form)
13.3.3.4
2.5
T
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13.3.3.2
2.6
T
Control Valve - Operation
13.3.3.1
1
2.7
T
Supervisory Devices
13.3.3.5
2.8
T
Backflow Preventer Assemblies
13.6.2
N�
2.9
T
Small Hose Connections* -
13.5.2.3
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13.5.3.3
2.10
T
PRV -- Fire Sprinkler Systems
13.5.1.3
2.14
T
Pressure Gauges - Calibration
5.3.2
2.12 T Small Hose Connections* 13.5.6,2.2
* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Clas1I, or 111
standpipe systems.
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13.3.4
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94.3.2.3
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14.3.2.4
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3.4
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14.2
No
3.5
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14.3
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a
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❑ Check here if additiorial Deficiencies and Commeni are listed on Form AES 9 Number attached:
0 See Correction Form AES •10 for corrected deficQcies. `, Number attached:
I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by
the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is h44Vperable
except as noted in the "Deficiencies and Comments" section of this form,
Print Name //A
Signature Date 5 ~vZ