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CITY OF BAKERSFIEl.D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKI..IST
1715 Chester Ave., 3rd f'loor, Bakersfield, CA 93301
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FACILITY NAME EPlr~l() ~. ~E:.6RA ,ODS
ADDRESS 4661 S;:1ðC.ilC)~..loW .Y . 0'1)
FACILITY CONTACT J-4aYCi t I Z:-UI~'
INSPECTION TIME
INSPECTION DATE 2 I Z.r lo"z"
PHONE NO. ~~?,~ o4-3r
BUSINESS ID NO. 15-210- N&..J
NUMBER OF EMPLOYEES
Section I:
Business Plan and Inventory Program
123~Dd-..-4
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o Routine ð-combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERA TION C V COMMENTS
Appropriate permit on hand N'SJ ?eÎl"'\.it- $ ,tc...
Business plan contact information accurate
Visible address
Correct occupancy
Verification of inventory materials t.JÞ..~ ~ r=.)C~
Verification of quantities ~ GAL P~,\IC ~uG-
Verification of location ,I\JSloé 'Pn,.1<. GV'1 UN~ S¡-vt-
Proper segregation of material
Verification of MSDS availability
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Verification of Haz Mat training .- -- -
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Verification of abatement supplies and procedures I . '
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EPIFANIO D. HERRERA, D.D.S.
Emergency procedures adequate Dentistry
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Containers properly labeled -.
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Housekeeping 4661 Stockdale Highway. Bakersfield, CA 93309
Fire Protection (661) 837,0435 . (661) 837-0850 fax
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Site Diagram Adequate & On Hand
C=Compliance
V=Violation
Any hazardous waste on site?:
Explain: L-Jk-"J.rE F;xe<,.
I2ÍY es 0 No
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Iv Business S esponsible Party
Questions regarding this inspection? Please call us at (661}-326-3979
White· Env. Svcs.
Yellow· Station Copy
Pink, Business Copy
Inspector: W (1Vi3-~
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CITY OF BAKERSFIEI.lD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKI..IST
171S Chester Ave., 3rd Hoor, Bakersfield, CA 9330J
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FACILITY NAME t;Pfr~lð b. ¡.{EIltEAA , f)DS
ADDRESS 466f ~"fëX1()tu.G' J..\.eJ Y 'bC¡)
FACJ.tITY CONTACTj.4a,yU' {(,' u iClly-\.- .'
INSP'ÈCTION TIME '
INSPECTION DATE '2.. I z r-/07"
PHONE NO. 'ð3"') - 04-3S-
BUSINESS 10 NO. 15-210- tV&:J
NUMBER OF EMPLOYEES
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SeCtion 1:
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Business Plan and Inventory Program
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o Routine ! ~ombined
Q Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
I
OPERATION C V COMMENTS
,
Appropriate perinit on hand f\.JEU rer"", It sAc-
Business plan contact information accurate
Visible address
Correct occupancy
Veri fication of inventory materials tJA-~ -re:- Ft",,~
Verification of quantities ç GA (,. PlJ).Ç."C ~ tJ6- : ,
..
. Verification oflocation II\"I$,( oé ~I{ IÏlØ1 r.J^'~ .$r'\l"-
Proper segregation of material
V erification 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
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C=Compliance
V=Violation
Any hazardous waste on site?:
Explain: '~:)T€ F" tXG!'L
Questions regarding this inspection? Please call us at (66JJ¡31~3979
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jJ/i4L{ 1J1fØi¡1
Business SUe" Responsible Party
White.. Env, Svcs.
Yellow· Station Copy
Pink - Business Copy
Inspector: W "vt2'~
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CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
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INSPECTION DATE
2 /2.Š (t>7.
FACILITY NAME 6Þ(ÇA~v 1). 4-t~a.
Section 4:
Hazardous Waste Generator Program
EP A ID #
o Routine
~ombined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS
Hazardous waste determination has been made
EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #)
Authorized for waste treatment and/or storage
Reported release, fire, or explosion within 15 days of occurrence
Established or maintains a contingency plan and training
Hazardous waste accumulation time frames
Containers in good condition and not leaking
Containers are compatible with the hazardous waste
Containers are kept closed when not in use
Weekly inspection of storage area
Ignitable/reactive waste located at least 50 feet from property line
Secondary containment provided ./ f'LGASE ~"c~€.
Conducts daily inspection of tanks
Used oil not contaminated with other hazardous waste
Proper management of lead acid batteries including labels
Proper management of used oil filters
Transports hazardous waste with completed manifest
Sends manifest copies to DTSC
Retains manifests for 3 years
Retains hazardous waste analysis for 3 years
Retains copies of used oil receipts for 3 years
Determines if waste is restricted from land disposal ¡
C=Compliance
V=Violation
Inspector: IAJ,IIJ'ES
Office of Environmental Services (661) 326-3979
White - Env. Svcs.
Pink - Business Copy
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BUSINESS NAME (Same as FACILITY NAt.1èOiÕãA:Qö¡ngBušiiïëš$'Ãs1-'" ,
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. CITY OF BAKERSFlap
FICE OF ENVIRONMENTA~ERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
D REVISE
200
(o(le (olin per material per Þuilding or al8a)
Page d
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I. FACILITY INFORMATION
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CHEMICAL NAME
Wk':, TE
COMMON NAME
CASIÞ
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201 CHEMICAl LOCATION - 0 0
, CONFIDEmtAL (EPCRA) - Yes No 202
203TGRiÖïi(op~(laïj--'- 204
-..---.--------.---------------.-----.--.--...
205
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TRADE SeCRET 0 Yes 0 No 206
It Subject to EPCAA reler to instructions
Fi Xet.
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Dyes DND 208
-----,. ._..__._-_._~ --.-.-'.
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CHEMICAL LOCATION
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FACIUTYIOIÞIIIJll[.',; ,IT, ..,¡-; ,·:--'If-MAP#foplio~-'-'
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,.:,;" "~:-::::~;,R~//lY~:~:{'" " ~ II. CHEMIc;AL I¡I¡FORMATION
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209 ; · f~Bif;E~~~i;
FIRE CODE HAZARD ClASSES (Complete if requested by local fire c:hfè¡r--------·--- --., "..-- -.'-" ..---, ' ,-----"--,,,,-
-..--....---.-.--..-. .-.------.---
210
DYes
ONo
212
CURIES
213
TYPE
o p PURE
-- _.~ _.----. -~._._"-_....._._- --.-
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214 ¡ LARGEST CONTAINER S-
PHYSICAL STATE
o s SOUD
FED HAZARD CATEGORIES
(Check all that ¡¡¡¡ply)
01 FIRE
ANNUAL WASTE
AMOUNT
2-8
o m MIXTURE
~ WAS,:
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L, ,
R;'OIOACTIVE
!lfh.,QUID
o 9 GAS
215
o 2 REACTIVE
o 3 PRESSüRE RELEASE
04 ACUTE HEALTH
o 5 CHRONIC HEAlTH
216
___.._._.._ _.___,...._.___.~____o.-.--- ____ ...- ..--.- -._--.--~
_._-- --------------.-. '-- - - -~_..._-.--_._-_......._._... _. .-..----.-----.
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217 _L~~~UNT ç ",__~,',~.L~~~!~~~_"'_,_"_
UNITS' J2J<c¡¡. GAL 0 ct CU FT 0 Ib LaS 0 In TONS
. It EHS, amount must be in Ibs.
STORAGE CONTAINER
(Check alt that apply)
o a ABOVEGROUND TANK
Db UNDERGROUND TANK
o c TANK INSIDE BUilDING
o d STEEL DRUM
De - PLAsTiëINONMETALLIC DRUM
01 CAN
o 9 CARBOY
o h SILO
o i FIBER DRUM
Cj BAG
Ok BOX
o I CYLINDER
o m GlASS BOITlE
~LASTIC BOTTLE
o 0 TOTE BIN
o p TANK WAGON
STORAGE PRESSURE
i 2
! 3 234
4 238
5 242
219 i
2211
STATE WASTE CODE
220
DAYS ON SITE
222
o q RAil CAR
o r OTHER
223
--.-.----....---.....--.
..- ~--_._-_.......__._._.
224
Þf.a AMBIENT 0 aa ABOVE AMBIENT 0 ba BELOW AMBIENT
._____._...__..____._.__.___._~._.._..... _...._.._ .. ...___ .~.... ...w.....__._____
r!fa AMBIeNT 0 aa ABOve AMBIENT 0 ba BELOW AMBIENT
':::~::fà~~f~%~if~{:2~:~~ÔÓÔ~;9A~f9~~~::~;3.1r~~5i):it: ".. ....
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o C CRYOGENIC
22S
,____., ___,__""._'..,.... ,__"b___""~~:_. ~..~~_9_~,~ ,L
231 I 0 Yes 0 No 232 !
---.. .-----.---- ------ -"'-'" _...-._-.-_." . _ --.-+-----.... .,. ---....-.. ---
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235 i 0 Yes 0 No 236 !
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SIGNATURE
229
233
237 ¡
241
245
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UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd