HomeMy WebLinkAboutUNDERGROUND TANK (2)
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:;UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
FACILITY NAME if J illd~ ~l!J/fJ;;:? INSPECTION TIME
----.--Th1A---~---~ _ -- -- - -- -- .---- - -- -.- ----- - --- --- - -- --- .- ---.-_._.__.._~--------._--_'-
ADDRESS :h :--A PHONE No. No. of Employees
34Ð _L_..:2L1Jh~~ ~_ __ J'ç_ _____ -- __ ____________ BUsIness IDNumber --- ...---1-.------.--.-.
FACllITYCONTACT
15-021-
Section 1: Business Plan and Inventory Program
o Routine
)( Combined
D Joint Agency
D Multi-Agency
D Complaint
(] Re-inspection
C V ( c=comPlianCe)
V=Violation
OPERATION
COMMENTS
'Ø 0 ApPROPRIATE PERMIT ON HAND
-~~------- ---------- ------- ------ - -------- .--- -- - ----
~ D BUSINESS PLAN CONTACT INFORMATION ACCURATE
--- ~-~----------- --- ---------------- -- --- --- - -- -
D VISIBLE ADDRESS
- -------------------- -----~----------- -----+ ------- -
(] CORRECT OCCUPANCY
.. ....__"___.____ _,_." .__.______._"__.._d,__... _. __._____"._.,_..,._ _.._.._. __.._.......__.._
On.._ _..._..______"'__ ..___._...._ __.___._..,
_'.__.n ._._n.. _
._ _.._0_·_._____'·_..._4.._· . ___ _.__.. ____ ,__..__._"._.____.. .___._.__..0_.._.
......-- '. -. --
______.________._______o__.____._______.._______~__m_. ._.__ ..__.__..._..__~.. _",_._~__.__. __...______._·_~_m_.__·__._··__ __..__,___.__.. _.____~._._ ____.__.
o VERIFICATION OF INVENTORY MATERIALS
__._~__._____________.__._______~.un.~_____.__.____ __~....._____.__.~ _.____ ~_..____. __. _______.__ .... .________._~.. _________....._..__.... ~O~__ _...._._ ._._.. _~.
D VERIFICATION OF QUANTITIES
_~._.__.___...____...___.____.__n__._.__.____,,__._______.____ ._.-__ ..__. ___._____...____._ __. _.____....____ _._______,,__....____..v.___.._ __. __,....__,,__ .__ .._
J'J__.~____~~~~~ATIO~ OF _~OC~T!~~______________.________... ._______.._______ ___ _ ... __.___._.__._____ .___.___
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_'!__ D ___~=~~:~TlON OF ~_~~~~~~~~B~~~.=__u._________.____ .. _____.___...____. _ ___u.._______ .__.____.uu ____.__
!...._~_~~IFICATI~N OF ~~~ T~~~~~._________.____._.. _____________.__ _. ___..____._.._ _ _________.
~--[J- VERIFICATIO"."'_ ABATE"E".' SUPP"ES.ANO_'.':x:''''':''.ES_____ .____ _ __. ___ __ _.__ _._ _ __ ___ _ _ .__ _ ._
-~~-~?r:~~~:::;::~~ATE---·---l- -- - --. _ ----
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..~___~_n~I~~!~~T:CT~~~ __ ________'_ ____.__ __'n ____ ___ ____ _ _______________ .___n_. _ __u___ ___ _ _ __ __._
D SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?:
DYES
~\NO
EXPLAIN:
~-------- -
G THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
Yellow - Station Copy
Pink.. Business Copy
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THIARA FOOD 1"1ART
3401 SO CHÐ::HER
BAKERSFIELD CA,93304
661-832-5900
SEP 28. 2004 9:49 AM
SYSTEr"1 SW;TUS REPORT
-. - - ~- -
ALL FUNCT IONS r'KiF:r"IAL
N\/ENTORY REPORT
1 : UNLEADED
) L Ut"1E
.LAGE
)% ULLAGE=
~ \JOLU~'1E
:IGHT
\TER \JOL
ITER
TEI1P
T 2: PREI"1 I 1.11"1
\/0 L UI1E
ULLAGE
90% ULLAGE=
TC \/OLUr"1E
HEIGHT
I,JATER IJOL
tJATER
TEf"IP
72J'3 GAl
::n81 GA
1781 GP
7075 (';f
65,10 I'
o (.;,._..
o . 00 I NCHEf::
88.3 DEG F
:3379 GALS
6621 GALS
Ei621 GALS
3:310 GALS
35,64 I NCHEf:~
12 GALS
0.80 I NCHEEs
88.8 DEG F
~ ~ ~ ~ ~ END ~ ~ ~ ~ ~
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FACILITY NAME~ ~ {J Fa:J ()1b1t
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENT At. SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
INSPECTION DATE 9 ¡fg/l>4-
Section 2:
Underground Storage Tank~ Program
o Routine Œi Combined 0 Joint Agency
Type of Tank 6W L (Q, I P. )
Type of Monitoring -fl T q
o Multi-Agency
Number of Tanks
Type of Piping
o Complaint
z..
J)IAJF
ORe-inspection
OPERA TION C V COMMENTS
Proper tank data on tile X
Proper owner/operator data on tile {
Pennit fees current X1
Certitication of Financial Responsibility ~
Monitoring record adequate and current ~
Maintenance records adequate and current tA
Failure to correct prior UST violations KJ
Has there been an unauthorized release? Yes No X"
Section 3:
Aboveground Storage Tanks Program
TANK SIZE(S)
Type of Tank
AGGREGA TE CAPACITY
Number of Tanks
OPERA TION Y N COMMENTS
.
SPCC available
SPCC on tile with OES
Adequate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
'fyes, Does tank have overlill/overspill protection?
C=Comp/iance
V=Violation
Y=Yes
N=NO
While - Fnv. Svcs.
Pink - Business Copy