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Home My WebLink About2021_10_19 Sams Club Job CardINSPECTION RECORD `A� BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street UST JOB CARD Bakersfield, CA 93301 Tel.: (661) 326-3979 Fes: (661) 852-2171 Post this Card at the Job Site and DO NOT Remove for Duration of Work DESCRIPTION DATE SIGNATURE TANK INSTALL PRIMARY PIPE-50PS1-1 HR SECONDARY PIPE-5PS1-1HR PRF_FI fl DESCRIPTION DATE SIGNATURE to t'm 11011 1 DESCRIPTION DATE SIGNATURE BUILDING ADDRESS: `4. � 5 (---1 C, JOB DESCRIPTION: OWNER: CONTRACTOR: j avk.-v v'O toa ;x A'Q-r NEW INSTALL DESCRIPTION I DATE SIGNATURE MODIFICATIONS MINOR / MAJOR DESCRIPTION DATE SIGNATURE DESCRIPTION I DATE I SIGNATURE FPRIOR TO OCCUPANCY OF ANY BUILDING, ALL UST AND/OR AST SYSTEMS SHALL BE TALLED, COMPLETED, AND ACCEPTED BY THEE BAKERSFIELD CITY FIRE DEPARTMENT. �41�t 1i101■J101109711111119r:11iyii PERMIT NO.: � FD 2165 (Rev. 3/2018) PREPARED 9/28/211, 11:45:35 PAYMENT DUE CITY OF BAKERSFIELD PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER: 21-10000538 5625 GOSFORb RD FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- PLAN CHECK FEES 99.00 MANDATED LEAK DETECT TEST 99.00 TOTAL DUE 198.00 Please present this receipt to the cashier with full payment. BILLING & PERMIT STATEMENT PERMIT # BAKERSFIELD FIRE i; Prevention Service: . 2101 H Street Bakersfield, CA 93301 PhnnA• . DEPARTMENT Fav- F0;1-JQCZ1-'11 71 SITE INFORMATION L04TTON OF PROJECT � � s PRO TY OWNER els XPE OF WOrRK (( Invt6t t 1(� fv � � � J� � i� L D � &'Be 5 NAME 1 1 U � jI '�', C PROJECT NAME M SLI`5 civil Lir� ADDRESS .o( ivy PHONE PROJECT ADDRESS � CITY g1� �,E5 L� STATE (2,A DE Z COj CONTRACTOR •' • CONTRACTOR NAME CA LICENSE # Tno Kyi v i Ur � C� TYPE OF LICENSEA EXPIRATION DATE 1 ' c 91 P ONE # oc, CONTRACTOR COMPANY NAME a� Kn 0 ,` EMAIL Fax # ADDRESS qn C CITY iet ZIP CODE Please make checks payable to CITY OF BAKERSFIELD, NO CASH Please. Thank you. • E:1 Alarm - New & Modification (minimum charge) FA $ 302 Over 10,000 sq ft $ 0 .0302 x sq ft ElAlarm - Minor Modification (Add 1 device/ Relocation of 2 devices) $ 99/hr (2 hrs minimum) _ $198 84 Sprinkler - New & Modification (minimum charge) FIRE $ 302 Over 10,000 sq ft $ 0 .0302 x sq ft Sprinkler - Minor Modification (<10 heads) $ 99/hr (2 hrs minimum) _ $198 84 Commercial Hood (New & UL 300 Upgrade Modification) FHD $ 244 Additional Hood $ 59/hood Commercial Hood - Minor Modification (add/move nozzle) $ 99/hr (2 hrs minimum) _ $198 84 Spray Booth (New & Modification) SB $ 244 ED Aboveground Storage Tank (1 inspection per installation) AST $ 207/tank 0 Each Additional Tank $ 99/Tank 0 Aboveground Storage Tank (Removal, Mod, or Inspection) ATR $ 129/tank Q Underground Storage Tank (Installation/Inspection) NI $ 913/tank Underground Storage Tank (Modification) MOD $ 913/site 0 Underground Storage Tank (Minor Modification) MTM $ 185/site Underground Storage Tank (Removal) TR $ 619/tank UST Testing: Fuel Mont Cert/SB989/Cath. Prot./Overfill Prev. $ 99/hr (2 hrs minimum) _ $198 NOTE: $99/hr for each type of test/per site/per UST system even if scheduled at the same time TT Oil well (Installation, Inspection, or re -inspection) X $ 99/hr 84 Tent TENT $ 99/hr 0 After-hours inspection fee 125 hr 2 hrs minimum = 250 Pyrotechnic (1 permit per event, plus an inspection fee $ 99/hr + (5 hrs min standby fee/insp) _ $59 of $99/hr during business hours) PYRO NOTE: After hours Pyrotechnic event inspection is @ $125/hr. 5 hrs min standby fee ins = 693 0 Re-inspection/Follow-up Inspection $ 99/hr 84 Q Portable LPG (Propane): # of Cages? $ 99/hr $4 0 Explosive Storage $ 244 84 Copying & File Research (File Research fee $51/hr) $ 0.02/page 84 Miscellaneous Site Plan Review (Carnival & Fairs/Vehicle $ 99/hr 84 FD2021 (Rev 05/21) APPLICATION TO PERFORM ELD/LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION (Please note that these are separate individual tests and will be charged per separate tVpe testaucordingly.) PERMIT # 0 ENHANCED LEAK DETECTION 0 LINE TESTING 0 TANK TIGHTNESS bkUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 ® Fax: 661-852-2171 Page 1 of I 0 SB -989 SECONDARY CONTAINMENT 11 OVERFI" PREVENTION FD2095 (Rev 03118) SITE INFORMATION ERCILITY C + LA 9 1 q NW4E Ea PHONE # OF CONTACT PER'SON I c r to os o's ADDRESS s ADDRESS I '. e r4 ---) 4 -) Go J\a Baice rs�( of d OWNER NAME C1 10 OPERATOR NAME sayy-1115 C, I a (0 PERMIT TO OPERATE # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? 0 YES 13 NO TANK # VOLUME CONTENTS $4ww. i 6-w rem I V1 TANK TESTING COMPANY TESTING COMPANY TAnKnOlu!n NAP4E & PHONE OF CONTACT PERSON MAILING ADDRESS Lf I �T 9-nkre nse CfrC-11C S014+1k 1 e V,%ne- (,Vt C1 j NAME & PHONE # OF TERR SPECIAL INSPECTOR f 'k+ r i c CERTIFICATION # A a -a- C) TEST METHOD ,AVqtnL4a1 ICC # APPLICANT SIGNATU DATE THIS 'P'LlICATION BECOMES A PERMIT 'WHEN APPROVED APPROVED BY V DATE FD2095 (Rev 03118) UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Hazardous Materials Business Plan Inspection BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 FACILITY NAME INSPECTION DATE 10/11 v MV INSPECTION TIME ADDRESS � � � s�z � 3 HONE NO. NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 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; 1,11 Minor CERS Violation COMMENT ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080) 3010001 CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1) 1010008 VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) CORRECT OCCUPANCY (CBC: 401) VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) 1010004 VERIFICATION OF QUANTITIES (CCR: 2729.4) 1010006 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 CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5) 3030007 HOUSEKEEPING (CFC: 304.1) FIRE PROTECTION (CFC: 903 & 906) 3030032 SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) 1010005 ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO f Signature of Receipt r� Explain: Inspector: POST INSPECTION INSTRUCTIONS: • Correct the violation(s) noted above by • Within 5 days of correcting all of the violations, sign 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 6/2021) HAZARDOUS WASTE ; BAKERSFIELD FIRE DEPARTMENT UNIFIED PROGRAM CONSOLIDATED FORMS Prevention Services SMALL QUANTATY HAZARDOUS �: �-'� � � 2101 H Street �.: - Bakersfield, CA 93301 WASTE GENERATOR INSPECTION Phone: 661-326-3979 a Fax: 661-852-2171 Facility Name: !st7 A4141 C- j , A L.1-.3 Z F t—( Date: Site Address: 62v%(Z(cJ trz� �1-113 Time In: Time Out: Owner/Operator: Phone: EPA ID #J2 jak(j4)v� Type o_ f Inspection Routine Re-inspection/Follow-up C Combined Routine Inspection ❑ Joint Inspection ❑ Complaint - Focused ❑ Other ❑ CONSENT TO INSPECT GRANTED BY (Name / Title): , a .- Inspection may involve obtaining photographs, review and copying of records, and determination of compliance with hazardous waste handling requirements. C = Complaint: V = Class I, II or Minor Violation, C V HAZARDOUS WASTE RE UIREMENT N/A ERS rcviolation# COMMENTS Recordkee in /documentation Generator has an EPA ID number [22CCR 66262.12] 3010002 Hazardous waste determination made for all wastes 7 Analysis XGenerator Knowledge [CCR 66262.11 ] 3030005 Contin ency plan information posted near phone [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 copy(s) of manifest mailed to DTSC [CCR 66262.23(a)(4)] 3010011 Bills of Lading/receipts available [CCR 66262.40(a)] 3010010 LDRs available and complete [CCR 66268.7(a)] 3030006 Onsite recycling reported using UPCF HSC 25143.10] 3030001 Container/tank management Containers are in good condition [CCR 66262.34(d)(2)] 3030013 Containers are closed exce t when adding/removing[ CCR66262.34 d 2)] 3030017 Satellite containers at or near point of generation CCR 66262.34(e)(1)(A)] Empty containers are empty [CCR 66261.7] 3030007 Containers inspected weekly [CCR 66262.34(d)(2)] 3030019 Tanks inspected daily [CCR 66262.34(d)(2), 40CFR 265.201 ] 3030027 One container per 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]c` 3010016 Accumulation Time Limits Waste is accumulated not more than 90/180/270 [CCR 66262.34(d)] 3030010 Empty containers mans ed within one year [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 recyclable materials marked properly [HSC 25143.9(a)] 3050005 Universal waste container properly labeled CCR 66273.34] 3030008 Used oil filters marked "drained used oil filters" [CCR 66266.130] 3030004 Date written onspent lead -acid batteries CCR 66266.81 a 6)(B)] 3030003 "Used Oil" marked on all used oil tanks/containers CCR 66279.21 )] 3030007 Tank marked with "haz waste" , contents, start date [66262.34(f)] 3030007 Treatment, Transport and Disposal/Other Havepen-nit/authorization to do treatment [HSC 25136.2] 3040003 Waste sent with authorized transport en. eligible) CCR 66263.41] 3050001 Waste disposed of to authorized point/party [HSC 25189.5(a)] 3050002 Failed to properly handle appliance wastes HSC 25212(a)] Fire Protection [66262.34(d)(2)] 3030032 Print and sign in this box for receipt of this report. Signature does not imply agreement with findings only receipt of report. INSPECTOR fc, .�. t. POST INSPECTION INSTRUCTIONS: Correct the violation(s) noted above by Within 5 days of correcting all of the violations, sign and return a copy of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H St. Bakersfield, CA 93301 Signature (that all violations have been corrected as noted) Date FD2171 (Rev 1/2019) White — Prevention Services Yellow— Station Copy Pink- Business Copy FIRE PREVENTION INSPECTION BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 FACILITY ADDRESS / DATE FEE FACILITY NAME j { W CITY, STATE, ZIP 3 i C_ i 7 BUSINESS OWNER'S NAME AND ADDRESS MANAGER'S NAME PH NO. BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP PH NO. OCC TYPE OCC LOAD NO. OF FLOORS OCG USE RISER DATE b� We /Dry Sprinkler System Type of Alarm System CONSTRUCTION TYPE HIGH RISE BLDG SQ/FT OF BLD { I l 4 I1 11YES ❑ NO CORRECT ALL VIOLATIONS VIOLATION CHECKED BELOW NO. REQUIREMENTS 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (CFC COMBUSTIBLE WASTE /DRY 3 04.1.1 ) VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its safe disposal. (CFC 304.3.2) Note: applies to containers over 40 gallons. COMBUSTIBLE STORAGE Relocate combustible storage to provide at least 3 feet clearance around motor fuse box/fire door (CFC 604.3) 4 Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the top to the extinguisher not more than 5 feet above the floor. (CFC 906.5 & 906.9) EXTINGUISHERS 5 Provide and install (amount) _____ approved (type & size) __________________ portable fire extinguisher to be immediately accessible for use in (area) _____________________________ (CFC TABLE 906.3) Re -charge all fire extinguishers. Fire extinguishers shall be serviced at least once each year, and/or after each use, by a person having a valid license or certificate. (CFC 906.2) Provide and maintain "EXIT" sign(s) with letters 6 or more inches in height over each required exit SIGNS (door/window) to fire escape. (CFC 1013.6.1) 8 Provide and maintain appropriate numbers on a contrasting background and visible from the street to indicate the correct address of the building. (CFC 505.1) 9 Repair all (cracks/holes/openings) in piaster in (location) ______________________________________. FIRE DOORS/ FIRE SEPARATIONS Plastering shall return the surface to its original fire resistive condition. (CFC 703.1 ) 10 Remove/repair (item & location)_________________________________________________________ , Self-closing doors shall be designed to close by gravity, or by the action of a mechanical device, or by an, approved smoke and heat sensitive device. Self-closing doors shall have no attachments capable of preventing the operation of the closing device. (CFC 705.2.4) EXITS 11 Remove all obstruction from hallways. Maintain all means of egress free of any storage. (CFC 1031.3) 12 Provide a contrasting colored and permanently installed electric light over or near required exit (location) ______________________________ to clearly indicate it as an exit. (CFC 10 0 8) STORAGE 13 Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire escapes/stair shafts are to be maintained free from obstructions at all times.) (CFC 1003.6) 14 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved ELECTRICAL APPLIANCES electrical outlets where needed. (CFC 604.5) 15 Remove multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (CFC 604.4.2) Commercial Hood 16 Automatic Fire Extinguishing systems shall be serviced at least every 6 months CFC 904.12.5.2 17 Commercial cooking systems shall be operated and maintained in accordance with code (CFC 607) OTHER 18 Violations of Section (CFC 5608.1) & 8.44.040 (B.M.C.). M' C e.. ( t CL., S lc C t U- ( ot C_ 001 F tec.'�t ( aS %, -,1r_( r N L< S '54c a ,& k t r, A r -C.. s f '1414( v•e, C Etjc_(, I -�, 1 #i (;C. M. i C S S` Lx .. •.I f4 " Cox t • 1 �.+ �1e �; 1 ,,.\ e,�? c +f �t C CORRECTION DATE Correct the violations noted above by: G k• to 4co QL CUSTOMER: ---'= It +j (Signature) (Please Print Name Legibly, Title) C F. C. CALIFORNIA FIRE CODE C.B.C. CALIFORNIA BUILDING CODE / r INSPECTOR:�'� f� �i,l' �, e, lr ' �� NO. ; '�rp -� sJ�v B.M.C. BAKERSFIELD MUNICIPAL CODE N. F. P.A. NATIONAL FIRE PROTECTION ASSOCIATION N.E.C. NATIONAL ELECTRIC CODE White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2022 (Rev. 02/2020) .j:W BAKERSFIELD FIRE DEPARTMENT UNIFIED PROGRAM INSPECTION CHECKLIST Prevention Services Division B F R :s F j �� 2101 H Street SIRE Bakersfield, CA 93301 A R TM T Underground Storage Tank Program Phone: 661-326-3979 Fax: 661-852-2171 NOTICE TO COMPLY / SUMMARY OF VIOLATIONS MINOR VIOLATIONS Owner/Operator: -Facility: � ,�1 . < <J += (-(V(5 Address: ❑ There were NO violations observed during p this inspection. fil, r" Q Notice to Comply: Minor Violations were found during this inspection as noted in the following Summary of Violations. The violations indicated in this inspection report must be corrected within 30 days, unless otherwise noted. Formal enforcement may be initiated for any violations noted, and for those not corrected in a timely manner. This report does not represent that there are no other violations at this facility. A re -inspection may occur to determine compliance status. SUMMARY OF VIOLATIONS Item # VIOLATION REQUIREMENT FOR CORRECTION OF DATE FOR VIOLATION CORRECTION /// �/ fil, r" 0- 01 rg co 41 0/,7 k X-7 4,)A, (A rM121i".*5 VC4'.I�C' bo_ccavao) IInspectors Received by: Signature: [Phone: 6 r- �.• - �� Print Name: [Date: Date: CERTIFICATION OF RETURN TO COMPLIANCE I certify that the violations noted above on this Notice to Comply/Summary of Violations have been corrected. I have personally examined any documentation attached to the certification to establish that the violations have been corrected. [Signature: Title: [Print Name: Date: White — Business Copy Yellow — Business Copy to be sent in after Return -to -Compliance Pink — Prevention Services Copy