HomeMy WebLinkAboutcalifornia resources_ OIL WELL INSP 4.6.21OIL WELL SAFETY PAGGRAM
OIL ELl.SPECTION
FIELD NOTES
BAKERSFIELD FIRE DEPT,
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
White — Prevention Services Pink - Business Copy
Page of
FD 2080 (Rev. 03/19)
Ill
.DATE CO MPLETED INSPECTION:
ri
LEA,IjE:
WELL #:
LOCATION:
f 0;
ADDRESS:
CITY:
ZIP CODE:
ERS)d
NAME:
�HONE-N
CELL NO.:
NAME:
HONE O.:
CELL NO.:
NAME:
PHONE NO.:
CELL NO.:
is
r.
.... ....
-
YES ❑
YES*
(Z
F E E
YES ❑
YES'y
3 76,
YES ❑
YES
4
YES ❑
YES 1:1
FEE
5
YES I--]
YES ❑
FEE
6
YES ❑
YES 1:1
FEE
7
YES 1:1
YES ❑
FEE
8
YES ❑
YES ❑
FEE
9
YES ❑
YES ❑
FEE
10
YES 1:1
YES ❑
FEE
11
YES ❑
YES ❑
FEE
12
YES ❑
YES ❑
FEE
TOTAL # OF WELLS
White — Prevention Services Pink - Business Copy
Page of
FD 2080 (Rev. 03/19)
Ill
INSPECTIONS
BUSINESS PLAN &
INVENTORY PROGRAM
UNIFIED PROGRAM INSPECTION CHECKLIST
Section 8:
Lease:
Well No.:
Location:
Date Completed:
Oil Well Inspection
i 0(�j Ces()Ly
(eAc
i�s' dill I t
OFpAr��
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
Page 1 of 1
i--Cl C
OPERATION
C
V
COMMENTS
Reportable Haz -Mat on -Site (Business Plan requirement)
Well location 25 feet from Tanks or Sources of Ignition
Well Location 75 Feet from Dedicated Public Street
Well Location 100 Feet from Miscellaneous Buildings
Well Location 300 Feet from Public Assembly Building
No Well Discharge to Drainage Canals, etc.
On the ground within 25 feet of
No Combustible Waste Well Site or Tanks
Sumps Less Than 12 Feet Wide and Fenced
Blowout Prevention in Place
Signs Properly Posted
Proper Fire Protection on Site
, ]�') C� � LOeA t �45.pe�e_� u = uompiiance v = violation
COMMENTS:
Inspector:
Well Site Responsible Party
Questions regarding this inspection? Please call us at (661) 326 -3979
White — Prevention Services Pink - Business Copy FD 2161 (Rev. 03/19)