HomeMy WebLinkAboutBUSINESS PLAN 10/22/2004
UNIFIED PROGRAM INSPECTION CHECKLIST
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SECTION 1 Business Plan and Inventory Program ;'
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
FACILITY NAME INSP~ION DATE INSPECTION TIME
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ADDRESS . ~~\t::U HONE No. No. of Employees
FACILlTYCONTAC-;1B:Z¿-S---------.---------------------- _~J_Y______ - ---.-~---"--~- -------_.----- ---.-.. ~-------_.- ---- --~-- _.- ---.-...- ----. .- ----
Business ID Number
15-021-
Seètion 1: Business Plan and Inventory Program
Ji Routine
l] Combined
l] Joint Agency
l] Multi-Agency
l] Complaint
l] Re-inspection
C V
( C=Compliance )
V=Violation
OPERATION
COMMENTS
~ l] ApPROPRIATE PERMIT ON HAND
_________._______._~._____.__~___~____ .______________......_____....__.__n.. ....___________... .._____n____ ..__.. _..,___ ._.. ,... ..__ n..__._.
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l] l] BUSINESS PLAN CONTACT INFORMATION ACCURATE
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16. l] VISIBLE ADDRESS
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JJd l]' VERIFICATION OF INVENTORY MATERIALS ?
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l] VERIFICATION OF QUANTITIES 13J J '1'~J 1I-3D
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." l] VERIFICATION OF HAZ.MAT TRAINING
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j( l] HOUSEKEEPING I
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~ l] FIRE PROTECTION I
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l] SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?:
l] YES
~No
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
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White· Environmental Services Yellow - Station Copy Pink - Business Copy
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LOWES
SiteID: 015-021-001999
Manager KEITH CARR
Location: 7825 ROSEDALE HWY
City BAKERSFIELD
BusPhone:
Map : 102
Grid: 28A
(661) 588-6420
CommHaz : High
FacUnits: 1 AOV:
CommCode: KCFD STA 65
EPA Numb:
SIC Code:5211
DunnBrad:00-699-7142
Emergency Contact
DAMON CHAPPELL
Business Phone:
24-Hour Phone :
Pager Phone :
/ Title
/ MGR ENV AFFAIRS
(704) 758-6005x
(888) 429-6281x
( ) - x
Emergency Contrct / Title
IUJI'fM ChRR J/lArry .,f,;'""",,ÞtJSTORE MGR
Business Phone: (661) 588-6420x
24-Hour Phone : (800) 300-5693x
Pager Phone : ( ) - x
Hazmat Hazards:
Fire Press
ImmHlth
Period :
Preparer:
Certif'd:
ParcelNo:
to
Phone: (336) 658-4000x
State: NC
Zip : 28697
Phone: (336) 658-4000x
State: NC
Zip : 28697
TotalASTs: = Gal
TotalUSTs: = Gal
RSs: No
Contact : DAMON CHAPPEL
MailAddr: 1605 CURTIS BRIDGE RD LPS 7
City : WILKESBORO
Owner
Address :
City
LOWES, HIW
1605 CURTIS BRIDGE RD LPS 7
: WILKESBORO
Emergency Directives:
. r, ~he~¡'r' J. ;Pt11t¥J__.... Do h,ambi' cArt¡fv !hat I have
Or''!}'). *)1' ppnã:f;;)!nrt) .'
rev¡~~~~;eJ ihe attacned t¡azardous materials manage-
ment plan for ~w(,S and that it along with
(Name of Business)
any corrections constitute a complete and correct man-
agement plan for my facility.
f~~p"
S,gnature
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Date
-1-
10/19/2004
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F LOWES
f= Hazmat Inventory
p== MCP+DailyMax Order
SiteID: 015-021-001999
By Facility Unit
Fixed Containers at Site
PROPANE
PROPANE
DIESEL
E
E
F P
F P
IH
IH
G
G
L
9
9
9
DailyMax Unit MCP
792.00 FT3 Hi
720.00 FT3 Hi
1500.00 GAL Low
Hazmat Common Name...
specHaz EPA HazardS Frm I
-2- 0
10/19/2004
SiteID: 015-021-001999 9
Facility Unit: Fixed Containers at Site 9
F LOWES
f= Inventory Item 0001
== COMMON NAME / CHEMICAL NAME
PROPANE
Days On Site
365
Location within this Facility Unit
REAR OF BLDG NEAR LOADING DOCK
Map:
Grid:
CAS#
74-98-6
STATE - TYPE
Gas Pure
PRESSURE ---- TEMPERATURE
Above Ambient Ambient
CONTAINER TYPE
PORT. PRESS. CYLINDER
Largest Container
33.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
792.00 FT3
Daily Average
600.00 FT3
%wt. I
100.00 Propane
HAZARDOUS COMPONENTS
~
CAS#
749861
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Hi
HAZARD ASSESSMENTS
Ag.Defined1:
MISC. LOCAL AGENCY DATA
Ag.Defined2: Ag.Defined3: Ag.Defined4:
Ag.Defined5:
Ag.Defined6: Ag.Defined7:
Ag.Defined8:
Ag.Defined9: Ag.Define10:
- Ag.Define11
-3-
10/19/2004
SiteID: 015-021-001999 9
Facility Unit: Fixed Containers at Site 9
F LOWES
f= Inventory Item 0003
=== COMMON NAME / CHEMICAL NAME
PROPANE
Days On Site
365
Location within this Facility Unit Map: Grid:
FRONT OF STORE/BLUE RHINO PROPANE EXCHANGE PROGRAM
CAS#
74-98-6
STATE - TYPE
Gas Pure
PRESSURE
Above Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
PORT. PRESS. CYLINDER
Largest Container
20.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
720.00 FT3
Daily Average
600.00 FT3
%wt. I
100.00 Propane
HAZARDOUS COMPONENTS
G;]
CAS#
749861
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Hi
HAZARD ASSESSMENTS
Ag.Defined1:
MISC. LOCAL AGENCY DATA
Ag.Defined2: Ag.Defined3: Ag.Defined4:
Ag.Defined5:
Ag.Defined8:
Ag.Defined6: Ag.Defined7:
Ag.Defined9: Ag.Define10:
I- Ag.Definel1
-4-
10/19/2004
SiteID: 015-021-001999 ì
Facility Unit: Fixed Containers at Site ì
F LOWES
f= Inventory Item 0002
= COMMON NAME / CHEMICAL NAME
DIESEL
Days On Site
365
Location within this Facility Unit
REAR OF BLDG NEXT TO GENERATOR
Map:
Grid:
CAS #
STATE - TYPE
Liquid Mixture
PRESSURE
Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
ABOVE GROUND TANK
Largest Container
1500.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
1500.00 GAL
Daily Average
1500.00 GAL
%Wt. RS CAS#
100.00 Diesel Fuel No. 1 No 70892103
HAZARDOUS COMPONENTS
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No NO/ Curies / / / Low
HAZARD ASSESSMENTS
Ag.Defined1:
MISC. LOCAL AGENCY DATA
Ag.Defined2: Ag.Defined3: Ag.Defined4:
Ag.Defined5:
Ag.Defined6: Ag.Defined7:
Ag.Defined9: Ag.Define10:
Ag.Defined8:
- Ag. Define11
-5-
10/19/2004