HomeMy WebLinkAboutBUSINESS PLAN 10/20/2003
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UNIFIED PROGRAM 1~'ECTlON CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
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Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
INSPECTION DATE INSPECTION TIME
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PHöN~ ÑÕ~of Em-ployees -
'17t( -ll4ll_!1 0_______.
Business ID Number
15-021-0bZZG:> t
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FACILITYCONTACT (¡, \ r:>
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Section 1: Business Plan and Inventory Program
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o Combined 0 Joint Agency r::J Multi-Agency r::J Complaint
ORe-inspection
D Routine
c V
( C=Compliance )
V=Violation
OPERATION
COMMENTS
o (J ApPROPRIATE PERMIT ON HAND
---~--------'----"-----------------
---- \~----~-r4[Tçþ---¿~~-~-------·-·----
o BUSINESS PLAN CONTACT INFORMATION ACCURATE
------.----..-..-.-----.----.-,-'-----.--- -- -- ----------- .__._._---_.__.~,-- -~--------._-~------- .----.-.-....--.------.... -_._--_.~-
rJ VISIBLE ADDRESS
._.~------_._-----_._--------- ..._-, --_._------------~-,- _._-"----~_._---_._~..__._-_._....._-----_._-_.,..._..---,~.._~_.-
CORRECT OCCUPANCY
-----------~-------_.._-~-----~ ---_.._--._.__._--_._-_.__.._----_.._-~_._-_.__._--~--._-------_._--~..__._.~----
VERIFICATION OF INVENTORY MATERIALS
--.------------.--.-.-,- .---------..-----.-. ------_._-_._------_._-------~--_.- -~-_..._-- .~'._-_._._--
VERIFICATION OF QUANTITIES
------------.----.------................ ---,----.--.---..--.------'---------.-.-..-.--.'-,----------_.~----,_._.-.._--,--
VERIFICATION OF LOCATION
----------------- --------------_.._-.--------------._-------~------------..-.
PROPER SEGREGATION OF MATERIAL
------------------------,- .._------.--+--------- -.-.-..----,---------.-------------.--,...
VERIFICATION OF MSDS AVAILABILlTYE
---~------._---_. .-----.-- ----,_..-._------- ------_.._~---------------~----.--_._---
VERIFICATION OF HAT MAT TRAINING
.______._____.~_____ ----------··--------.----------·--_-·0_..-----·---·----____________
C] ~ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
CJ ~ EMERGENCY PROCEDURES ADEQUATE
--------. ....----------.-- ..--------..-.--..--..-.::--:---..-------..--. .---..-..---.-----....---.
_~~ONTAINERS PRO~ERLY LAB~LE~_____n________ .~~ \l. ___~~-=_~_~~_.___._.______________
~ g_~~USEKEEPING_____________+__---------_--_-----_--_- ._.___._.__
~ rJ FIRE PROTECTION i
---------_._-~------_._-_._--~, -----------_..:.-.--_._-----_._----_._---_..-~----_._-,.~---------
CJ SITE DIAGRAM ADEQUATE & ON HAND
-----_._._-------~_._.._-- ----_._-_._--_."_._~-_.._'--~._-~------~_.._--_.__..~----~---,--
ANY HAZARDOUS WASTE ON SITE?:
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~YES
Cf'A.. ,
/
o No
EXPLAIN:
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C?\~.
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
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Inspector Badge No. Business Site Responsible Party
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White - Environmental Services
Yellow - Station 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 JFloor, Bakersfield, CA 93301
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FACILITY NAME Uf\JIJtS'dnJ
ADDRESS S-~Ol "'"f1'2-vX"f"U1'l AJ
F ACILITY CONTACT KC...j .~ 'C4rcJt.
INSPECTION TIME
INSPECTION DATE 9 ("Lo fof
PHONE NO, '32-4 - 00> (
BUSINESS ID NO. 15-21 0- ~'\J
NUMBER OF EMPLOYEES 40
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Sectiou1l 1:
Business Plan and Inventory Program
o Routine ~ombined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS
Appropriate pennit on hand ¡Jét,J ~<JZ.IV' , l'
Business plan contact infonnation accurate
Visible address
Correct occupancy
Veri fication 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
AII1lY hazardous waste on site?:
Explain:
o Yes~o
¥tr- ~ \(1\1.<. C£ .
White - Env. Svcs,
Yellow - Station Copy
Pink - Business Copy
Inspector:
W/~
Questions regarding this inspection? Please call us .8t (661) 326-3979
Business Site Responsible Party
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CITY OF BAKERSFIEI.D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFlED PROGRAS'¡ INSPECTION CHECKLIST
1715 Chester Ave., 3rd Hoor, Bakersfield, CA 93301
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fACIÙTY NAME VNh!IS'drJ
ADDRESS. '>'2.0~ ~v¡:cru~ AJ
FACIL~TY CONTACT_ ~C.".J ~~t1'(1G1t
INSPECTION TIME
INSPECTION DATE 9/--e..o IOf
PHONE NO, '3 '2-&1= 001 V
BUSINESS ID NO. 15-21 0- ~C~
NUMBER OF EMPLOYEES 40
10 :21yA-- II~ ..
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Section 1:
Business Plan and Inventory Program
o Routine ~ombined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection'
>.
OPERA nON c v COMMENTS
Appropriate pennit on hand wCÞJ (tC~~ ,'(
Business plan contact infonnation accurate
Visible address
Correct occupancy
Verification of inventory materials ..
Verification 'of quantities
Verification of location .. '.
,-'" .
Proper segregation of material P'
V~rification 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=Compliarce
V=Violation
¡ I
Any hazardous waste on site?:
Exp/áin:
DYes ~o
~el\ ~ \(¡~~ ~ .
I
White - Env. Svcs,
Yellow - Station Copy
Pink - Business,Copy
Inspector:
W/~
, .
I
....
Questions re~arding this inspection? Please call Uj;o&t ~61) 326-3979
Business Site Responsible Party
8 CITY OF BAKERSFIEL.
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
6
~A \ 1 FACILITY INFORMATION
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FACIL/lY ID #
,·.··.·.·:,·;J;:;:¡~i.~;'nl~i0~'~~;¡~~;{~~;t.~!;ì;,;'ÈÆ~~IT!~tí:f~&~~~Ç~tlpij,·',J¡::;~;.;~~í
1 Year Beginning 100 Year Ending
101
3 BUSINESS PHONE
102
SITE ADDRESS
~ «;0/ "T<Lu:x'(LJJ
103
CITY
OUN&
BRADSTREET
COUNTY
104 CA ZIP
105
106 SIC CODE
(4 Digit #)
107
108 :
OWNER MAILING
ADDRESS
113
CONTACT MAILING
ADDRESS
119 '
NAME ~6;A ~() 123 NAME K(~ «. I c..U-rt:JL. 129
TITLE ç--r-¡.J M.6-k!... 125 TITLE II (...v éN& 130 I
BUSINESS PHONE 3")L¡ - 2b¡q 126 BUSINESS PHONE 131
24-HOUR PHONE 5~4 - '2~Î $' 127 24-HOUR PHONE 3ð3, - 2331 132 ¡
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PAGER # 128 PAGER # 6"316 - 2. 3, 2-G 133 i
Certification: Based on my Inquiry of those Individuals responsible for obtaining the information. I certify under penalty of law that I have personally examined
and am familiar with the Information submitted In this inventory and believe the Information Is true. accurate. and complete.
SIGNATURE OF OWNERIOPERATOR DATE 134 NAME OF DOCUMENT PREPARER 135 :
!
NAMES OF OWNER/OPERATOR (print)
136 TITLE OF OWNER/OPERATOR
;
137 I
FORM Z1'?IO ('/99)
·
CITY OF BAKERSFIELD FKRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
17 t 5 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME
UN t J I Stð,J
INSPECTION DATE
<9IW~1
Section 2:
Underground Storage Tanks Program
o Routine 0 Combined
Type of Tank
Type of Monitoring
o Joint Agency 0 Multi-Agency
Number of Tanks
Type of Piping
o Complaint
ORe-inspection
OPERA nON
COMMENTS
Proper tank data on tile
Proper owner/operator data on file
Penn it fees current
Yes
No
Section 3:
Abovegrou.nd Storage Tanks Program
TANK SIZE(S)
Type of Tank
f ()ðO
'Dw5
AGGREGATE CAPACITY
Number of Tanks
't~o
OPERATION Y N COMMENTS
spec available tJ Vít-
spec on file with OES ~ V4
Adequate secondary protection t/'
Proper tank pJacarding/labeling ,/0
fs tank used to dispense MVF? )-. Vt.t ßÞD::.oP GG~
If yes, Does tank have overfill/overspill protection?
C=Compliance
V=Violation
Y=Yes
N=NO
Inspector:
Office of Environmental Services (805) 326-3979
White - F.nvo Svcs.
uJ I AfG-S
Business Site Responsible Party
Pink - Business Cory