HomeMy WebLinkAboutBUSINESS PLANr
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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan-and Inventory Program
A_ E R S P I P
F/RE
aRrM r
Prevention Services
900 Truxtun Ave., .Suite 210
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 872-2171
FACILITY NAME _
~
~lG INSPEC ION D TE
5 Z~~ INSPECTION TIME
~
r
- . -
ADDRESS ~
t ~ ®~ 28 ~
S-~ PHONE NO.
3 zs - ~?sl NO OF EMPLOYEES
_
FACILITY CONTACT BUSINESS ID NUMBER
15-021- d 1 S = p2~ - Od
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^ -- -
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
~j ^ BUSIt1eSS PLAN CONTACT INFORMATION ACCURATE ~ \\
p~+D w v.
^ VISIBLE ADDRESS
~
^ CORRECT OCCUPANCY j ~'~-- ~ `'~~ ~
~
^ VERIFICATION OF INVENTORY MATERIALS C~ n~ ~ r'~e g; ~ d ~~St` { ~
^ VERIFICATION OF QUANTITIES ~ 1_ ., a ~~~.Z C~y1 ~~~~ .~
^ VERIFICATION OF LOCATION ~ --~~~ t c7 C ~~ ~ v
^ PROPER SEGREGATION OF MATERIAL
^ VERIFICATION OF MSDS AVAILABILITY ~" ~~ 1
^ VERIFICATION OF HAZ MAT TRAINING
,^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
^ EMERGENCY PROCEDURES ADEQUATE
^ ^ CONTAINERS PROPERLY LABELED A ,~
/ `~
^ HOUSEKEEPING
-~- ^ FIRE PROTECTION ~NT`~ MA's ~ 2
,~. ^ SITE DIAGRAM ADEQUATE & ON HAND y
ANY HAZARDOUS WASTE ON SITE? p^YES ,~NO
EXPLAIN: ~' ~.r~~19.~ L~ ~6.y~/ Ot W'~.S~C ¢ {~J~1~ ~iT-~"G 1
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL us aT (ss1) 326-3979
~'~'G~_
Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station #
White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/OS
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST ,~
1715 CheSter Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME -~t. ~. aL~'C~ '~oC~ INSPECTION DATE 3
Section 4: ~ardous Waste Generator Program EPA ID ~ ~ O~
~ Routine ~ Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection
OPE~TION C V COMMENTS
H~ardous w~te dete~ination h~ been made
EPA ~ Number (Phone: 916-324-1781 to obtain EPA ID ~)
Authorized for w~te treatment anWor storage
Repoffed rele~e, fire, or explosion within 15 days of occu~ence
Established or main~ins a contingency plan and training
H~ardous wrote accumulation time frames
Conmine~ in good condition and not leaking
Confiners are compatible with the h~ardous wrote
Conmine~ ~e kepi closed when not in use
Weekly inspection of storage ~ea
Ignitable/reactive w~te located at ie~t 50 feet from prope~ line
Second~ con~inment provided ~ ~ ~~
Conduem daily inspectiOn of tanks
Used oil not con~minated with other h~ardous waste
Proper m~agement of lead acid batteries including labels
Proper management of used oil filte~
T~spom h~dous wrote with completed m~ifest
Sends manifest copies to DTSC
Re~ins m~ifes~ for 3 ye~
Re~ins h~dous wrote analysis for 3 years
Re~ins copies of used oil receip~ for 3 yea~
Dete~ines ifw~te is restricted from land disposal
C=Compli~ce V=Violation ,
Office of Environmen~l'Se~ices (661) 326-3979 g~ness~ite R~ponsible Pray
White - Env. Svcs. Pink - Business Copy
FFICE OF ENVIRONMENTA"E SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
<'"" HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one fom~ per mate~fal per bu~i~ or ama)
3
~E~L LO~TION .~ ~1' CHEMI~L LO~T~N -
~ : ~NFIDE~L (E~)
CHERYL ~ 205 T~DE SE~
"' ~7 ,.
~N ~ EHS*
FIRE CODE H~ ~ES (~pl~e if ~t~ by I~ fire ~ieO .........
'. 2~0
~PE ~ p PURE ~ m ~ ~ w WASTE 2:: ~ ~O~ACT[VE ~Y~ ~ No 212 ~ CURIES 213
PHYSI~STA~ D s SOLID ~1 LIQUID ~ g ~S 214 ~ ~RGEST~NNER 215
FED ~RD ~TE~ES ~ 1 FIRE ~ 2 R~ ~ 3 PRESSU~ REL~E ~ 4 ACU~ H~L~ D 5 CHRONIC H~ 216
(~ ~1 mat app.)
~U~WA~ 217,~ ,~I~M 218 ,~ AVENGE 219 STA~W~DE
A~U~ [ DAILYA~U~ [ DAILYA~U~
UNITS' ~ ~ ~ ~ ~ CU ~ ~ lb ~S ~ ~ TONS ~1 DAYSON
* If ~S. ~nt must be in lbs.
STOOGE ~AINER ~ a A~VEGROUND T~K ~ e ~NM~ALLIC DRUM D i FIBER DRUM ~ m G~SS BO~E ~ q ~IL
(Check afl ~at app.)
~ b UNDERGROUND TANK ~ f ~N ~ j BAG ~ n P~STIC BO~LE ~ r O~ER
~ c T~K INSIDE BUILDING ~ g ~R~Y ~ k BOX ~ o TO~ BIN
~ d S~EL DRUM ~ h SIL0'" ~ I CYLINDER ~ p T~K WA~N
STOOGE P~S~U~ ~ a A~IE~ D ~ A~VEA~IENT ~ ba BELOWAMBIE~
~ c CRYOGENIC ~5
1 ~ 227 ~Y~ ~No ~8
2 ~ ~ ~1 ~Ym ~No232 ~3
3 ~ ~ 2~ ~Y~No 236 ~7
~8 ~9 ~Y~ ~No 2~ 241
242 243 ~ Y~ ~ No 244 2~
UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wI:x:I
James N. Clark, D.D.S.
180~5 Twenty-Eighth Street
Suite 101
Telephone (661) 325-$751
Fax (661) 327-2735