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UN11=I~ED`'PROGRAM INSPECTION CHECKLIST B e R s r . 0 900 Truxtun Ave., Suite 210
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SECTION 1 ~ Business Plan and Inventnrv Program a~rM Tel.: _(661) 326-3979
FACILI AME
~ INSPECTION DATE
- INSPECTION TIME
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ADDRESS PHONE NO. NO OF EMPLOYEES
22 ~~~ 3-7~-3~ ~
FACILITY CONTACT
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BUSINESS ID NUMB15-021 ~~~ ~ ~/~~~
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Section 7: Business Plan and inventory Program ~~~'"l
~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
.:C V ( C=Compliance- OPERATION
V=Violation . COMMENTS
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^ APPROPRIATE PERMIT ON HAND
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^ BUStfIeSS PLAN CONTACT INFORMATION ACCURATE
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^ VISIBLE ADDRESS
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L'7 ^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
Cf ^ VERIFICATION OF QUANTITIES
LAY ^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
^ VERIFICATION OF MSDS AVAILABILITY
^ ^ VERIFICATION OF HAZ MAT TRAINING ~ ~~/.~.
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- ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
[~ ^ FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZAJR~DO~US WASTE ON SITE? EI~'ES ^ NO
EXPLAIN: !h'-L~' S !~~ fi~1C~ l ~l ~ d r ~.-
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
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Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station #
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' White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ~:.
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+ CARDS A~"I'O REP~,IR __________________________________ SiteID: 015-021-001744 +
Manager _: BusPhone: (661) 324-3225
Location: 1229 BEALE AVE Map 103 CommHaz Low
City BAKERSFIELD Grid: 28A FacUnits: 1 AOV:
CommCode: BFD STA 02
EPA Numb:
SIC Code:7538
DunnBrad:
+______________________________________________________________________________t
Emergency Contact / Title Emergency Contact / Title
CARLOS PAGUAGA / OWIVIER /
Business Phone: (661) 324:-3225x Business Phone: ( ) - x
24-Hour Phone (661) 634-0264x 24-Hour Phone ( ) - x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards:
Contact ~ Phone: (661) 324-3225x
MailAddr: 1229 BEALE AVE State: CA
City BAKERSFIELD Zip 93305
Owner CARLOS PAGUAGA Phone: (661) 634-0264x
_ Address 1131 NILES ST State: CA
City BAKERSFIELD Zip 93305
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
~ParcelNo:
Emergency Directives: ~
PROG A - HAZMAT
PROG H - HAZ WASTE GEN
PROG T - ABOVEGROUND STORAGE TANK ENT'D DEC 0 8 2006
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Bakersfield Fire Dept.
l~NI~hED PROC~I~AAA INSPECTION CHECKLIST Enironmental services
- ., -~. 4 - 1715 Chester Ave
SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301
Tel: (661)326-3979
FACILITY NAME n ~ INSPECTI N DATE INSPECTION TIME
ADDRESS PHONE No No of Employees
~, FACILITYCONTACT Business ID Number
e Las ~~9-GcJ C~ 15-021-00/~`~'~/
Section 1: Business Plan and Inventory Program
Routine ^ Combined O Joint Agency ^Mutti-Agency ^ Complaint ^ Re-inspection
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V IV=Vioationncel OPERATfON
J COMMENTS
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PERMIT ON HAND
LK ^ APPROPRIATE
QY^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
~^ VISIBLE ADDRESS
~^ CORRECT OCCUPANCY
~^ VERIFICATION OF INVENTORY MATERIALS
LY ^ VERIFICATION OF QUANTITIES
L~1" ^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
^ ^ VERIFICATION OF MSDS AVAILABILITYE ~ ~ / /l
^ ^ VERIFICATION OF HAT MAT TRAINING ~ ~ ~.
^ L~"'~VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
^ LN EMERGENCY PROCEDURES ADEQUATE
^
CONTAINERS PROPERLY LABELED
^ F'IOUSEKEEPING - -- -
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l~ ^ FIRE PROTECTION ~
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE: LlYES ^ NO
EXPLAIN: ~~ ~ ~ ~y ~ C712_ Q G
• QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US A7 661 ~ 326-3979
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Inspector (Please Print) Fire prevention 1st-InlShik of Site
White -Environmental Services YelVow -Station Copy
Plnk -Business Copy
Party (Please
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°°~y ~' CITY OF BAKERSFIELD FIRE DEPARTMENT
~~ ~ OFFICE OF ENVIRONMENTAfl. SERVICES
~~' , `p UNIFIED PROGRAM[ INSPECTION..CIIECKLIST
°:~~"~o~,p° 1715 Chester Ave., 3'd Floor, Baker'stield, CA 93301
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FACILITY NAME ~ 1J.C,~ I tl ~ ~c i `~ ~ V~?-INSPECTION DATE 1 rZ '"~ 7' C) ~
ADDRESS- Zit ~= 9~1-~=^~ ~y'~I'HONE NO. ~a'-f - ~ ~. ~ ~
FACILITY CONTACTCyA2~vs ~-t/A`1~ BUSINESS ID NO. 15-210-
INSPECTION TIME 2 c5 ~ ~ aJ NUMBER OF EMPLOYEES- ~,~ n~_
Section 1: Business Plan and Inventory Program ~~ c
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^ Routine ^ Combined ^ Joint Agency ^Multf-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 c;v~lE` ~
Verification of Haz Mat training ~~
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled ~
Housekeeping ti.
Fire Protection ~.t2-~ + CAL- ~ ~ 7`%yVc • S t
Site Diagram Adequate & On Hand
C=Compliance V=Violation ~ ~~~ t ~' ~i;l_~ J.~,e} Z~I'vt ~T ~~! Sc~1~ S S ~~ AN
Any hazardous waste on site?: Yes ^ No
Explain: ~I.c4S•r~ MdTdIL. s 1' ~. 11~~-~,,q~#~brJS.
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Questions regarding this inspection? Please call us at (6 ) 326-3979
White -Env. Svcs. Yellow -Station Copy Pink -Business Copy
usiness Si a esponsible Party
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Inspector:
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To: Betty Wilson
From: Captain Rutledge 2-C
Date: 12/29/2002
Betty, this business has been in operation at this location for over 2 years and he has not filed as a
hazardous waste generator. He was previously conducting the same type of business at a different
location and did have a business plan on file and was annually inspected by the fire department.
I conducted a haz -mat inspection on this facility and am forwarding the inspection form to you.
The business owner has been informed that he is required to file as a hazardous waste generator
and needs to update his business plan information.