HomeMy WebLinkAboutcrc oil well insp _2019INSPECTIONS ��L
BUSINESS PLAN � r
INVENTORY P ROGRAM
UNIFIED PROGRAM INSPECTION CHECKLIST
Section 8: Oil Well-Inspe tion
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Lease: I f a k
Well No.:
Location:
Date Completed: C1
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BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
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OPERATION
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
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COMMENTS
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
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SPECIAL CONDITIONS:
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COMMENTS:
Inspector:
Questions regarding this inspection? Please call us at (661) 326-3979
Well Site Responsible Party
White — Prevention Services Pink - Business Copy FD 2161 (Rev. 03/19)
DEPTO
BAKETHDRSPIELD FIR., U ��� Prevention Services
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ML WELL SAFETY PROGRUAM
2 101 H Street
X
Bakersfield, CA 93301
-3979
Tel.: (661) 326
O[IL WELL INSPEGT�ON
Fax: (661) 852-2171
RE D NOTES
LEASE l SITE INFORMATION:
DATE COMPLETED INSPECTION:
LEAS WELL #: LOCATION:
CITY: ZIP CODE:
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CONTACT PERSON(s):
NAME: PHONE NO.: C L NO
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NAME: PHONE NO.: CELL NO.:
NAME: PHONE NO.: CELL 40.:
WELL NAME(s):
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3
4
5
6
7
9
10
12
13
14
15
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Page Of
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PUMPING NOT PUMPING
(4 One) (CAPABLE) FEE
One)
YES ❑ YES FEE
YES 0 YES'
FEE
------- -----
YES ❑ YES
-- FEE
------- --
YES ❑ YES 1:1 I FEE
YES ❑ YES ❑ FEE
YES ❑ YES ❑ FEE
YES ❑ YES ❑
FEE
YES 1--J YES E] I
FEE
0 YES
YES 1:1 FEE
YES 1:1 YES ❑ FEE
YES 1:1 YES 1:1
FEE
YES ❑ YES 1:1
FEE
I YES ❑ YES 1:1
FEE
YES ❑ YES ❑
FEE
YES CJ- YES 1:1 I FEE
TOTAL OF VVELLS
FD 2080(Rev. 02/11)