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Home My WebLink AboutBUSS-ES INSP CHECKLIST 12/14/2002 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This _~ermit is issued for the followin_~; [] Hazardous Materials Plan rn Underground Storage of HazardOus Materials [] Risk Management Program PERMIT ID # 015-021-002143 12 Hazardous Waste On-Site Treatment BLOCKBUSTER #06512 LOCATION: 5600 CAIJFORNIA M ,AKERSFIEPD CA 93309 ..~ .... ,. ':~>~ "~ · . /"~ . ~ . . '~' :~ ':"'"'">' ' OFFICE OF ENVIRONMENTAL SER VICES' '- ~' 1715 Chester Ave., 3rd Floor Approved by: ~Rai~pi/rHucy'DI~i Issue Date Bakersfield, CA 93301 Offic¢ofEvironme.~TServices '~ Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date:June 30, 2003 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME~-'~IO¢ ¥...%g~'e~ )0L'%"~ZINSPECTION DATE iZ- ~ ~ ~ ~- PHONENO.~- ~%~ ADDRESS ~~} _-~.' -~--~: FACILITY CONTACT_ ~,~~ ~e BUSINESS IDNO. 15-210- ~SPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~l Routine {~ Combined I~ 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 Emergency procedures adequate ~ '"".,~",, ~ Fire Protecfio/ Site Diagram ~dequate & On H,and C=Compliance C3~%' ~ k~%3- ¥\ ~-- \ ;~O~¢,.--,.. ,-'-~ ~'~ed~.~k3y'', Any waste on site?: ~ Yes ~ No ~+ ~(8 $~ Questions H~$e {:all us nt (661) 326-39~9 Business Site Respom le Party White - Env. Svcs. Yellow - Station Copy Pink - Busine~ ~ Inspector: ='~'~~~'~: FAX ~ra nsm ittal B A I( F. R $ F I F. L D Cover Sheet CALIFORNIA Bakersfield Fire Dept. Or'ce of Environmental Services 1715 Chester Ave. · Bakersfield, CA 93301 FAX No. (,66[..) 326-0576 · Bus No. (:6.61.) 326-3979 Today's Date z~/2a/o/ Time 4,'~c~ No. of Pages // 04/23/01 15:54 8661 326 0576 BFD HAZ MAT DIV ~001 *** ACTIVITY REPORT *** TRANSMISSION OK TX/RX NO. 9714 CONNECTION TEL 6332594 CONNECTION ID START TIME 04/23 15:50 USAGE TIME 04'45 PAGES 11 RESULT OK ( PHONE CALL AREA CODE NUMBER EXTENSION FAX¢ ~ ~EASE CALL g~ ,, ~~ -- WlLLCALL MESSAGE ,, AGAIN CAME TO SEE YOU WANTS CITY OF RSFIELD F R'[MENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 ADDRESS ~-~:~,~ f__./Jct~f'~,A. ~ PHONE NO. ~, 3'3 FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~(~Routine [~l Combined [~] Joint Agency [~l Multi-Agency [~] Complaint ~l Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials ~t 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 ~ Explain: ~__~.~//,~/· J Z/~,~t2~~. Quesfion[,reg~ding ~is ~specfion? Please call us at (661) 326-3979 ~i~[~ ~ite Respo~le Party White- Env. Sees. Yellow- Station Copy Pink- Business Copy Inspector: ~ t ~ CITY OF BAKERSFIELD I -" OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST' -" 1715 Chester Ave., 3r~ Floor, Bakersfield, CA 93301~ f,' _ .... FACILITY NAME '~LO~'a---~O6 g'' ! 2...INSpEcTION DATE t ADDRESS ff~,e~.3 ~0,a-,r--csa~,~, ~.~ ?HONENO. FACILITY CONTACT · BUSINESS ID NO. 15-210- INSPECTIONTIME NUMBER OF EMPLOYEES ! · , . ~ .... ~i'l.~' Section 1: Business plan:and Inventory Program . ~(.Routine ' [21 Combined [21 Joint Agency [21 Multi-Agency [21 COmplaint [] Re-inspect OPERATION. C V COMMENTS: Appropriate permit on hand .. Business plan contact information accurate ~ · Visible ~ddress ·: Correct occupancy ' 'Verification of inventory materials" ~"~l't2 ~. Verification of quantities " ~-'t7 Verification of location . ~ (,,-'9-404C~ ,~ · 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=Violati0n Any hazardous waste on site?: [] Yes ~.~ Questions regarding this inspectiog? Please callus at (661) 326-3979 ,d.~u"~i[i~ Site Responsdff~le Party · White- Env. Svcs. Yellow- Station Copy 'Pink- Business Copy Inspector: OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 932101 (661) 326-21979 FACILITY INFORMATION Page Of I I I I I I I I I I I I I BUSINE~E (~ ~ FACILI~ ~E ~ O~ ~ B~I~ ~) 3 BUSINES~ PHONE ~02 SITE ADDRESS ~ ~t~[~ ~ ~' DUN & 1~ SIC CODE lO7 B~DSTREET (4 Digit ~) COU~ : OPE~TOR ~E l~ ) OP~TOR PHONE I OWNER ~ME 111 ~ O~ER PHONE O~ER ~ILING : ADDRESS CONTACT ~ME l~? J CONTACT PHONE CONTACT ~ILING ADDRESS j Cl~ 1~ J STATE 1211 ZIP PAGER ~ l~ PAGER ff Ce~fl~on: Bas~ on my Inqul~ of ~ose i~lviduals ~nslble for ob~lnlng ~e Info~a~on, I ce~l~ under penal~ of ~aw mat ~ ~ve pe~nally ~amin~ and am famaar N~ ~e InfomaUon submlU~ In ~ls Invento~ a~ believe ~e In~aUon Is ~e, a~mte, and ~mp~ete. J SIG~ OF O~E~R DATE 1~ J ~ME OF ~CUME~ ~P~R 1~ j I NAMES OF O~E~TOR (~nt) 1~ TITLE OF O~E~OPE~TOR 27'50 (~/~)