HomeMy WebLinkAboutUST-ENVIERNMENTAL SERVICES 10/5/2004
UNIFIED PROGRAM INIECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enuonmental Services
1715 Chester Ave
Bakersfield. CA 93301
Tel: (661)326-3979
FACILITY NAME t" ,- r11 Þ" r IN~T~ DATE INSPECTION TIME
--------------EJ-lJ]L\Je--~----~-JfJ11t'1L---- __________m______________ -lß--~-þ4-- __ _ __ ___m_________
ADDRESS q Z--~ F /0lAJeV" sr P~~Zë:D7gz. NO/ Employees
FACILlTYCONTACT ---------------------------------------- --- -----------~ BusinešiïiÕ Numbe,-- ------ - - ------- ____
I 15-021-
Section 1: Business Plan and Inventory Program
LJ Routine
KCombined
LJ Joint Agency
('] Multi-Agency
LJ Complaint
LJ Re-inspection
c V ( C=Compliance )
V=Violation
OPERATION
COMMENTS
_~----~--AP~~~R~~~~~-~~~~~~-~~----- ___________________ _ __ __ ______ _________________ _ __ _________ _ ___ _m___m _____ ____
~- 0 BUSINESS PLAN CONTACT INFORMATION ACCURATE
_ ---------
~__~_~_.~_____________ __.___.__________ __ _.___...__. ...____..._._____.._______ _.._ . _ __......___.__.___.. ._..._._..... _____no_.n.. .....___...._. .~_.m..._._.
g LJ VISIBLE ADDRESS
_::1__~-.::----:.__,.__._______.____.______..______.~________.__..___._._____ ___
S( LJ CORRECT OCCUPANCY
-------------------------------------------------------,--------
~ LJ VERIFICATION OF INVENTORY MATERIALS
"" ___".___..____.__..._.._m. ___ _...._____ ___.__._....__._..."__._ ___....__.. _..
- ----
____m__
'.__..~_...._~"____h _,_._~__._ _ __._,__.__._._._..._..._.__,4_..._. __.___ __.__"__ .____~_.___ ..._.__...
-----------------".-------.-----------..-----------------
___ __. _____ __ _ _____,_,u __ "_.._____.__.._ ___+,_~____..,_._.___,.... n. __ _.__.___ _._
.. . . - . -- .-.-
~ LJ VERIFICATION OF QUANTITIES
________.._._._.____._______~___________._._____.._.._...________....__.....__.,........._. __.___.____________. ___. .__..__........ _.__.____m_._..._.____.._.~n.'.__ __. _ ........__ .___. __ .___
_~_~____~~~~~~ATIO~~_~OC~~I~~______________________ ._ ______________________________u__ _ . ._____u_ _
J( 0 PROPER SEGREGATION OF MATERIAL
____.___________.___________._._____ .__" __.__._________.._...._.....____._ _. ._.___________._ __ .._ _.__._._._.._ no __ . ... _..______.__..__._ _._~.__" _____ _..____ __._. .__."
~ 0 VERIFICATION OF MSDS AVAILABILlTYE
..______~_._.___._____.____._.______________._______. ...".__.__.__.__._.___.. .___...__ ___._._._.___..__._________.._ .__ _ .. __...._...__..._._____ n___· ___.._.. ._'''_.._____. _.._ _.__. ______.._._
. LJ VERIFICATION OF HAlIMAT TRAINING
________________________________,_________, ________________, ___nn________n ______________________ _ ______________ ___ ____________________
_ _~~___ V~~IFICATI~~~__ ABA~=~~~T SUP~~IE~_~_~~_~~~C~~~~:.S_ _,_____________________________ ______ _____________________ _ __ _________ __
__ LJ EMERGENCY PROCEDURES ADEQUATE
u_ _______ ______ _ ___ ___ _ _ _ _____ _ un __ _ __ ____ ___ __ ____ --.J- ,_ _ __ _ __ __ _ n __ _
~ LJ CONTAINERS PROPERLY LABELED I
____________u_ _____ ___ __ __ _m__ ___________ ____ ---L---- ___ ___ ___ _ ____m_ __ _ ___________________________________
-~ _~___~~~_SEKE:~~~_____________:_________ n_ --------- ---1-----'------ __m__'___'__
'ta, 0 FIRE PROTECTION
.-..________.__.______~__. _~_._.___ .__u._____..__._____..._.____. _____.._..__._n_ ___.___ ___..__._.. _.._______ _._._ ___ no_ ___ .__...__.______..__. . __ . __" ._._.._._ .__ __._._..___.__ _
2( LJ SITE DIAGRAM ADEQUATE & ON HAND
i
~- --- -- - --
-.. '_...--~_._-
.. .-----..-..-.--
- --.--.-.------.-.-..--------. - . --. --- - ......-
- ..____u___._...
ANY HAZARDOUS WASTE ON SITE?:
LJ YES
)(NO
EXPLAIN:
--~-t2
o Inspector
HIS INSPECTION? PLEASE CALL US AT (661) 326.3979Ä ~
/- '~
-~g;; N,:--- _n_ '.,.. -. _._-.""........",,;. . Po", __on --
White . Environmental Services
Yellow - Slallon Copy
Pink - Business Copy
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CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave" 3rd }'Iool', Bakersfield, CA 93301
FACILITY NAME_Flowe. -r 5,... V)'1 \ r'11 ýYJP/+-
INSPECTION DATE 10/5/ó4-
I
Section 2:
Underground Storage Tanks Program
o Routine QfCombined D Joint Agency
Type of Tank ---'2 VU I'--Q., ~
Type of Monitoring CtLM
o Multi-Agency 0 Complaint
Number of Tanks L
Type of Piping ~
ORe-inspection
OPERA nON C v COMMENTS
Proper tank data on tile 'f...
Proper owner/operator data on tile X
Penn it fees current ì<
Certification of Financial Responsibility 1--
Monitoring record adequate and current 1-
Maintenance records adequate and current '}..
Failure to correct prior UST violations 1-
Has there been an unauthorized release? Yes No X
Section 3:
Aboveground Storage Tanks Program
AGGREGATE CAPACITY
Number of Tanks
TANK SIZE(S)
Type of Tank
OPERA nON Y N COMMENTS
SPCC available
SPCC on tile 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
White - Fnv, Svcs,
Pink - AlIsiness Copy
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FLOWER S'f MINI MART
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BAKERSFIELD CA 93305
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O(;T 5., 2004 1 I : 14 Hi"1
SYSTEM 81ATUS REPORT
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