HomeMy WebLinkAboutINSPECTIONSBakersfield Fire Dept.~
Enironmental Services
1715 Chester Ave
SECTION 1. Business Plan and Inventory Program Bakersfield, CA 9330l
Tel: (661)326-3979
ADDRESS ................................................. IP~ON~'' ........ NoYof E p oyee
FACILITYCONTACT IBusiness--i~u-mber
! 1.5-021 -
"'" '~"" '~'~ ~--:i :~:i','~ ':~':.' ?",i?'i::'~''~' :,': sebtion ~lfBUsiness Plan. and In~entorypr°gram i'~' '
[] Routine ~Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection
C V (C=Cor. pliance~ OPERATION COMMENTS
~, V=Violation
~ [] APPROPRIATE PERMIT ON HAND
~[~ [] BUSINESS PLAN CONTACT INFORMATION ACCURATE
~i~ []'1 VISIBLE ADDRESS
~ [] CORRECT OCCUPANCY '
[] VERIFICATION OF INVENTORY MATERIALS
[] VERIFICATION OF QUANTITIES ............................................................................
[] VERIFICATION OF LOCATION
~ [] PROPER SEGREGATION OF MATER,AL
'~ [] VERIFICATION OF MSDS AVAtLABILITYE
.~ [] VERIFICATION OF HA'~IAT TRAINING
[] VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
[] EMERGENCY PROCEDURES ADEQUATE
'~ [] CONTAINERS PROPERLY LABELED
~ [] HOUSEKEEPING
f.._[] FIRE PROTECTION
[] SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?: [] YES ~ No
EXPLAIN: "' .~
White - Environmental Services Yellow - Station Copy Pink - Business Copy
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3r'~ Floor, Bakersfield, CA 93301
Section 2: Underground Storage Tanks Program
[] Routine ~Combined [] Joint Age.ncy [] Multi-Agency [] Complaint [] Re-inspection
Type ofTa'nk ~ ~ L-- (t'q_. P, ]~ Number of Tanks g
Type of Monitoring .~_~-l--C--~.. Type of Piping ' ~-a~._} .~ (0, -P, )
OPERATION C V COMMENTS
Proper tank data on file
Proper owner/operator data on file "~
Permit fees current
Certification of Financial Responsibility
Monitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations
Has there been an unauthorized release? Yes No
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S) AGGREGATE CAPACITY
Type of Tank Number of Tanks
OPERATION Y N COMMENTS
SPCC available .
SPCC on file with OES
A&quate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
If yes, Does tank have overfill/overspill protection'?
C=Compliance V=Violation Y=Yes N=NO
Office of~i~h~nln[al-S'~ice.~l)3~79 Business Site Responsible Party
~ ~ White - Env. Svcs. Pink - Business Copy
' ITY OF BAKE{I FIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
NSPECTION RECORD
POST CARD AT JOB SITE
Facility ~'C3'3__ ,~'"~q'lc, a~ ~'t~r Owner
Add.ss G ~ I ~ ~C~ Add~
City, Z}~ City, Zip -'
INSTRU~IONS: Ple~e call roran ins~lor only when ~h ~up ofins~fions with the ~e numar am ~dy. ~ey.will mn in conseculive o~er beginning wilh
number I. ~ NOT cover wo~ tbr ~y numbe~ ~up umil all ile~ in I~I ~up am si~ offby the Pe~iuing AulhoHly. Following these instructions will
number or ~ui~d ins~lion visits ~d lh~mtb~ p~enl ~menl ora~i~ional r~. . _
TAN~ AND BACKFILL
: INSPE~ION: .: DATE 'INSPECTOR .... "
BackfillofT~k(s) "~ -::" "' : '''' : ;"" '
- .. :.....:' ...~'..=~;:-L '?.' .....
Sp~ T.t C~.ifi~i~ ~r'M~ur~tu~ M~ "J ~-~c-'_ :;J~.J ;~ ~.-:~ .:~'. -. ;~. '~'
........ -
Cath~ic P~t~ti0n of T~k(s) ' "' ": .? , .... ' '.
' ' ' PIPINGSY~EM ". .... ":¢..
..... .~.. ...
Piping & Race~y. w/Collation S~mp :, .~ .' .':, ;':-:'~'.':= ~: '~ ::?.~:~ ' :'
· Cat'lc ~t~ti°'~' ~y~te~Pi~i~ '~?, '" "'~-.-: '. '~;?.?;~:'~- q ';.~ '.=''~ .-~:, ~..;' ~ '?i'~
Dis~nser P~ ";: ~" · '":"-? , ,'. ',:: -'~ "
' " SECONDARY CO~AINME~, O~ILL PROTE~ION, LEAK DE~ION - " ,' . :. -, ,', .~;
Liner lns~llation -"T~k(s)' h ~. ?' "- .. ;.~- '% · '. ': '-': '; ................. .. -
Liner Installation-Piping"' :'-:. ' ;""" - - ' '."· ' ': .... .~"~ J i' '
_ _ · .
.. ' , '- . , , %?; '~,,~'~,~:
P~uct Compatible Fill Box(~) ' '..' :...
Leak ~t~toffs) for Annual Space-O.W. T~k(s) ............
Monitoring Well(s~sum~s) - H20 Test .::
Leak ~tection ~vic~s)~or Vados~Gmundwater
' . .
Spill Prevention Box~
' FINAL
Monitod.g:
Fill Box L~k
Monitodng Requi~men~ Type UtOtem.+ ~'t~
RECORI .
INSPECTION Bakersfield Fire Dept.
1715 Chester Ave.
Bakersfield, CA 93301
FACILITY NAME:
MANAGER NAME: FACILITY PHONE
BUSINESS OWNER NAME, ADDRESS, ZIP CODE
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS, ZIP CODE, PHONE No.
OCC TYPE ·[ OCC LOAD No. OF FLOORS I HI RISE BLDG. I RISER DATE
I
I
YES I-I NO El
I
VIOLATION NOTICE CORRECTION: DATEOFREINSPECTION
3.
10.
11.
12.
13.
14.
15.
NOTES
CUSTOMER: ,'~ ?--~:j'~ ['~ .C?-Li~/~'7 ~ FIRE PI~EV~NTION SERVICES
INSPECTOR: ~ t'~J~S ¢,~ No. "~' (661) 326-3979
WHITE ORIGINAL-OWNER YELLOW-INSPECTOR'S COPY PINK-FILE
FD1952
Bakersfield Fire Dept.
UNIFIED PROGRAM INSPECTION CHECKLIST I Enb'onmenta] Services
'== ' "" '" "'"""' ' '" ' ' ' ' ""' "' "'i 17 !5 Chester ^ye
SECTION 1 Business Plan and Inventory Program Bakersfield, CA 9330]
Teh {661)326-3979
[~.FACR. ITY NAME IINSPECTION OATE t INSPECTION TIME
· / ' 15-021-
Section 1: Business Plan and Inventory Program
~ Routine '~ Combined ~ Joint Agency ~ Multi-Agency I~ Complaint r'l Re-inspection
C V [ C=Compliance '~ OPERATION COMMENTS
~, V=Violation
s .........................................................................................................................................
-'~ VERIFICATION OF MSDS AVAILABILI~E
CONTAINERS PROPERLY ~BELED
~ SITE DIAGRAM ADEQUATE & ON HAND
ANY H~ARDOUS WASTE ON SITE?; ~ YES ~No
EXPLAIN:
..... InspectOr ............ ~dg~-~'~:: ............ --~~ Party
White. Environmental Services Yellow - Station Copy Pink - Business Copy
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CltECKLIST
1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301
FACILFI'Y NAME (~CC ,~q~.,4-lo/q ~--~- INSPECTION DATE q'3O 03
Section 2: Underground Storage Tanks Program
[] Routine ' [~ Combined~[],_Joi, 0.~/ Agency [] Multi-Agency [] Complaint [] Re-inspection
Type of Tank ,SUdta. ~¢
· Number of Tanks 3
Type of Monitoring ,~T'(w Type of Piping ,.60dS (~ d,., P. }
OPERATION C V COMMENTS
Proper tank data on file
Proper owner/operator data on file
Pennit tees current
Certification of Financial Responsibility
/
Monitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations /
Has there been an unauthorized release? Yes No
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S) AGGREGATE CAPACITY
Type of Tank Number of Tanks
OPERATION Y N COMMENTS
SPCC available
SPCC on file with OES
Adequate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
If yes, Does tank have overfill/overspill protection?
C=Compliance /] V=Violation Y=Yes N=NO
////
Inspector: ...~ d&_J'~ _
Office of Environmental Services (661) 326-3979 '"'"'Business Site Responsible
Party
White - Env. Svcs. Pink - Business Copy
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKI~IST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME 0)a~tc .h~O'~ ~L~ INSPECTION DATE f-o~3'O'~
ADDRESS &.E,.c ,5'T PHONE NO. ~31- i'I?g-
FACILITY CONTACT BUSINESS ID NO. 15-210-
INSPECTION TIME NUMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
{~ Routine ~°mbined [~ Joint Agency ~ Multi-Agency ~ Complaint I~ Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand (
Business plan contact information accurate
Visible address
Correct occupancy
Verification of inventory materials
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training L
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping ~..
Fire Protection
I
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?: [~ Yes [~ No
Explain: [/~~
Questions regarding this inspection? Please call us at (661)326-3979 -Business Site/~. esponsjble Party
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301
FACILITY NAME {~.C.~' .qlu:t_JdO'~ INSPECTION DATE q"
Section 2: Underground Storage Tanks Program
[] Routine [~ombined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection
Type of Tank ~O.}.c~ Number of Tanks
Type of Monitoring _~TC~ Type of Piping
OPERATION C V COMMENTS
Proper tank data on file
Proper owner/operator data on file
Permit fees current
/
Certification of Financial Responsibility
Monitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations
Has there been an unauthorized release.'? Yes No
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S) AGGREGATE CAPACITY'
Type of Tank Number Df Tanks
OPERATION Y N COMMENTS
SPCC available
SPCC on file with OES
Adequate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
If yes, Does tank have overfill/overspill protection?
C=Compliance /IV=Violation Y=Yes N=NO
Inspector:
Office of Environmental Services (805) 326-3979 Business Site Responsible Party
White - Env. Svcs. Pink - Business Copy
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME ()/l,*v, //141vt~ t,~R~_~t ~SPECTION DATE
ADDRESS [~3[ ~tc PHONENO.
FACILITY CONTACT BUSINESS IDNO. 15-210-
~SPECTION TIME NUMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
I~1 Routine [~Combined I~ Joint Agency ~ Multi-Agency ~ Complaint {~ Re-inspection
OPERATION C V COMMENTS
/
Appropriate permit on hand
Business plan contact information accurate k.,, /'
Visible address
Correct occupancy ~ /
Verification of inventory materials
Verification of quantities ~ /i
Verification of location C~ /'
Proper segregation of material L, /
/l
Verification of MSDS availability L,'
Verification of Haz Mat training L,,' /
/
Verification of abatement supplies and procedures L/
Emergency procedures adequate
/
Containers properly labeled
/
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand L, /
C=Compliance V=Violation
Any hazardous waste on site?: [~1 Yes ~No
Questions regarding this inspection? Please call us at (661) 326-3979 Business ~sp:?~arty
White- Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector:.
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME 0/llt')~ ~lto[ l~y.Ot'~ INSPECTION DATE lO[ 3/OJ
Section 2: Underground Storage Tanks Program
[] Routine ~] Combined {~[,Joint Agency [21 Multi-Agency [] Complaint [2[ Re-inspection
Type of Tank ,~0J~ (.~rt) Number of Tanks --~
Type of Monitoring ~'-F~ Type of Piping .~Co...q C<. ?"/
OPERATION C V COMMENTS
Proper tank data on file
Proper owner/operator data on file
Permit tees current
Certification of Financial Responsibility
Monitoring record adequate and current
Maintenance records adequate and current ~/
Failure to correct prior UST violations ~
Has there been an unauthorized release? Yes No
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S) AGGREGATE CAPACITY'
Type of Tank Number of Tanks
OPERATION Y N COMMENTS
sPcc available
SPCC on file with OES
Adequate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
If yes, Does tank have overfill/overspill protection?
C=Complian5 ~. V:Violation ¥:Yes N=NO ~.~f~
Inspector: _k~,4_, ;~~D /'~'~C~-
Office of Environmental Services (805) 326-3979 ~Bu~ine~s Site Responsible Party
White - Env. Svcs. Pink - Business Copy
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301
FACILITY NAME OIMOv, {/~t~n, [~.~ INSPECTION DATE
ADDRESS ~31 fitx~r ~' PHONENO. qSl' "'ilo
FACILITY CONTACT BUSINESS ID NO. 15-210-
INSPECTION TIME NUMBER OF EMPLOYEES
Section 1: Business Plan and'Inventory Program
[] Routine [~Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand
Business plan contact information accurate
Visible address
Correct occupancy
Verification of inventory materials
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures iL/
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand L/
C=Compliance V=Violation
Any hazardous waste on site?: [] Yes ~o
Explain:
Questions regarding this inspection? Please call us at (661) 326-3979 Business Sit~ Responsible Party
White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: ~
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME ()tll~ [Mt~ '/14Il. tic INSPECTION DATE
Section 2: Underground Storage Tanks Program
~l Routine [~ombined [] Joint Agency [21 Multi-Agency 121 Complaint [] Re-inspection
TypeofTank ~50d5 ~mcd Number of Tanks 3
Type of Monitoring !{T'G Type of Piping ,.~t,O~ (2 ~, 19. )
OPERATION C V COMMENTS
Proper tank data on file
Proper owner/operator data on file
Permit tees current
Certification of Financial Responsibility
Monitoring record adequate and current V/
Maintenance records adequate and current
Failure to correct prior UST violations L,/
Has there been an unauthorized release? Yes No
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S). AGGREGATE CAPACITY'
Type of Tank Number of Tanks
OPERATION Y N COMMENTS
SPCC available
SPCC on file with OES
Adequate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
If yes, Does tank have overfill/overspill protection?
C=Compliance V=Violation Y=Yes N=NO
Office of Environmental Services (805) 326-3979 Business Site Responsible Party
White - Env. Svcs. Pink - Business Copy
CITY OF BAKER~iELD
OFFICE OF ENVIRON~~~ SERVICES
1715 Chester Ave., Bakersfield, CA (805) 326-39'/9
INSPECTION RECORD
POST CARD AT .IOB SITE
INSTRUCTIONS: PI~~~~~~~~~~~.
T~
[ ~S~=ON [ DA~ ~R
I , I
C~c ~m of T~s)
PIPING ~EM
Pip~ & ~y w/~ll~
SECONDLY CO~NME~. O~L
~ ~1~ - T~s)
Vault Wi~ ~ Co--him
~ C~blm Fill
~ ~ ~ ~s)
~ ~s) for ~ S~D.W. T~s)
M~to~{ Well(syS~s) - H20 T~
M~ ~ ~s) f~ V~~
~ Spill ~i~ ~
FIN~
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CH ECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME O~lo~ ~,~, {q, lat'Y INSPECTION DATE
ADDRESS (0f:l{ _0m {,er PHONE NO. 631 ' 7103
FACILITY CONTACT BUSINESS ID NO. 15-210-
INSPECTION TIME NUMBER OF EMPLOYEES
Section 1.: Business Plan and Inventory Program
[~/l~outine [] Combined [] Joint Agency [] Multi-Agency [~l Complaint [] Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand
Business plan contact intbrmation accurate
Visible address
Correct occupancy
Verification of inventory materials
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training /
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?: ~l Yes [~ No
Questions regarding this inspection? Please call us at (805) 326-3979 Business Site ~esponsible Party
While- Env. Svcs. Yell,,,,,- Station Col,>, Pink- Business Copy Inspector: ~_~t~a6 ~
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME q)rl,~o, ~m', l/har~- INSPECTION DATE
Section 2: Underground Storage Tanks Program
~,/Routine [] Combined [] Joint Agency [~[ Multi-Agency [] Complaint [] Re-inspection
Type of Tank ._qtl_5 Number of Tanks $
Type of Monitoring /h t ~ ~ Type of Piping &t.~/5
OPERATION C V COMMENTS
Proper tank data on file
Proper owner/operator data on file
Permit fees current V
Certification of Financial Responsibility
Monitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations
Has there been an unauthorized release? Yes No t40
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S) AGGREGATE CAPACITY'
Type of Tank Number of Tanks
OPERATION Y N COMMENTS
SPCC available
SPCC on file with OES
Adequate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
If yes, Does tank have overfill/overspill protection?
C=Compliance V=Violation Y=Yes N=NO
Inspector:
Office of Environmental Services (805) 326-3979 Business Site Responsible Party
White - Env. Svcs. Pink - Business Copy