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Home My WebLink AboutBUSINESS PLAN 4/30/2008~~,- ~ ~-- ~~}~ ~, i ~, `~ ~t ,i~~ ~ RITE AID DRUG STORE #6195 9000 MIlVG AVE., SUITE #A I ti ~-- \' _ . _ _ _ (~ - I ~~~~ ~„ ~ ~„ ~w '\ F :, ~,~ i ~ ~~~ ~~ i= RITE AID DRUG STORE 6195 SiteID: 015-021-001893 Manager RON RICE Location: 9000 MING AVE A City BAKERSFIELD BusPhone: (661) 663-0171 Map 123 CommHaz Moderate Grid: 05C FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title~iS~Li RON RICE / MANAGER S-Ei~ / A Business Phone: (661) 663-0171x ~ ~ i ss hone: (661) 7.2~ 2 4 -Hour Phone ( 6 61) - 2 4 -Hour Phone ( 6 61) ~S-5 '--max 33z (o Pager Phone ( ) = ~ x. Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact ~~~~ ~~~ e~, Ko 4 ~ Phone • ( ~~ MailAddr: Q^~~~Hd£ A ~fQZC~ ~~''~`~ ~~PE ~rr ~~-~~ l~ State : -~- Mc city ,(~~„~~-~q:w~ Aft .z77a3 zip 93311-~=~~ X7703 Owner RITE AID Phone: (~6~G~~~~~1-~sx Address PO BOX 3165 State : PA 717 ~ ~~ ~"~0~;3 City HARRISBURG Zip 17105 Period to TotalASTs: = Gal Preparers TotalUSTs: - Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~ ENr°p ~ ~ ~ R PROG H - HAZ WASTE GEN ( ~ ~ ~~~, Based on my inquiry of those individ~:s;is responsii;ie for obtaining the information, t certify under penalty of law that 1 have personally - ' examined and am familiar with the information submitted and believe the information is true , accurate, and complete. ~" ~ ~°`"'"" / Si n tur Date ~ , ~~' 7S -1- 02/06/2007 z ~~ F RITE AID DRUG STORE 6195 SiteID: 015-021-001893 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PHOTOGRAPHIC DEVELOPERS R IH L 4.00 GAL Mod PHOTOGRAPHIC DEVELOPERS R IH L 4.00 GAL Mod PHOTOGRAPHIC FIXER IH DH L 4.00 GAL Low PHOTOGRAPHIC BLEACH IH L 4.00 GAL Low PHOTOGRAPHIC BLEACH IH L 1.00 GAL Low HELIUM F P IH G 440.00 FT3 Min PHOTOGRAPHIC STABILIZER IH L 28.00 GAL Min WASTE FIXER R IH L 5.00 GAL Min PHOTOGRAPHIC STABILIZER IH L 5.00 GAL Min -2- 02/06/2007 -3- ~ 02j06j2007 "f F RITE AID DRUG STORE 6195 SiteID: 015-021-001893 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PHOTOGRAPHIC DEVELOPERS Days On Site KODAK FLEXICOLOR DEVELOPER REPLINISHER LORR 365 Location within this Facility Unit Map: Grid: PHOTOLAB/CHEMICAL STORAGE AREA CAS# 123-31-9 Liquid TMixture ~mbRent~E ~ AmbientT~E ~ PLASTICTCONTAINERE AMOUNTS AT THIS LOCATION Lar est Container Dail Maxi um Dail Avera e g ~ ~ ~~ ~ - - GAL Q (~~0 GAL 7, ~ ~ GAL ntic,nrcl~vuJ ~vrirvlvaly 1 J ~Wt. RS CAS# 12.00 Potassium Hydroxide (~~1, Sec ~ No 1310583 3.00 Ethylene Glycol No 107211 7.00 Hydroquinone (EPA) No 123319 tiL-~GHtCL HJ JL"~SJ1~1~1V~1-J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Mod ~ Inventory Item 0009 Facility Unit: Fixed Containers at Site ~ COMMON NA H E IC N M / C EM AL AME PHOTOGRAPHIC DEVELOPERS Days On Site KODAK EKTACOLOR RA DEVELOPER REPLINISHER 365 L ti ithi thi F ilit it M G id U oca on w n s ac y n ap: r : PHOTOLAB/CHEMICAL STORAGE AREA CAS# 123-31-9 Liquid TMixture TAmbRent~E ~ AmbientT~E ~ PLASTIOCTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Avera~e - <<,0 5sr0v GAL l~.v~-~ GAL' iUa7 ~"" GAL t1tiGHtCLVUJ 1:V1~1rV1Vr,1V1J °sWt. RS CAS# 12.00 Potassium Hydroxide ~c~~ See ~~' No 1310583 3.00 Ethylene Glycol No 107211 7.00 Hydroquinone (EPA) No 123319 ri1~GEiCCL EiJ Jr,JJ1~1~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Mod -4- 02/06/2007 F RITE AID DRUG STORE 6195 SiteID: 015-021-001893 ~ ~ Inventory Item 0007 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PHOTOGRAPHIC FIXER Days On Site KODAK FLEXICOLOR RA FIXER & REPLINISHER 365 Location within this Facility Unit Map: Grid: PHOTOLAB/CHEMICAL STORAGE AREA CAS# 7783-18-8 STATE TYPE PRESSURE TEMPERATURE CONTAINER Liquid TMixture ~-Ambient Ambient DRU~B'~ AMOUNTS AT THIS LOCATION ~ d/V'T ~ Largest Container Daily Maximum Daily Average _ I : Q ~" " GAL ~ 2 . D ~8 GAL ~ ~ ~ _ _ GAL t1AGHKLVUb lLV1~lYV1Vi'1V15 %Wt. RS CAS# 5.00 Acetic Acid Solution ~ ~ ~~ No 64196 2.00 Boric Acid ~ ~-ee ~ • No 10043353 46.00 Ammonium Thiosulfate ~ No 7783188 Y1HGF~KL L~J ~~JJ1~11';1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Low ~ Inventory Item 0010 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PHOTOGRAPHIC BLEACH Days On Site KODAK EKTACOLOR RA BLEACH FIXER & REPLINISHER 365 Location within this Facility Unit Map: Grid: PHOTOLAB/CHEMICAL STORAGE AREA CAS# 12124-97-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture~ Ambient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Containe Daily Maximum I Daily Average j~ ~ GAL ~Q ~0 GAL. 13: 4, e„~6.8' GAL ri1~laKKL V U .7 lL V1~lY V1V J;1V 15 °~wt . Rs cAS# 10.00 Ammonium Thiosulfate s,e~ ctT-t-~x t.ecr CC~~ No ~ 7783188 5.00 Sodium Bisulfite No 7631905 5.00 Acetic Acid Solution No 64196 riEIGHiCL 1~.7.7L" JJ1~1L"1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Low -5- 02/06/2007 F RITE AID DRUG STORE 6195 SiteID: 015-021-001893 ~ ~ Inventory Item 0006 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PHOTOGRAPHIC BLEACH Days On Site KODAK FLEXICOLOR RA BLEACH REPLINISHER NR 365 Location within this Facility Unit Map: Grid: PHOTOLAB/CHEMICAL STORAGE AREA CAS# 12124-97.-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Containe Daily Maximum Daily Average ~ ZS 2 GAL ~ 1 0 GAL , lv ~,,~6'~ GAL riHGL-1KLVUJ trvl~lrvlvL'~lvl~ oWt. RS CAS# 15.00 Ferric Ammonium Ethylene D' mine Tetraacetic Acid No 0 10.00 Ammonium Bromide a;}~c~-~, See No 12124979 5.00 , Ammonium Nitrate No 6484522 ti1~GE1KL H~a1S~~1~1L"~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Low ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit 'Map: Grid: SE END OF ICE CREAM COUNTER CAS# 7440-59-7 ~GasATE ~pureE -~AboveSAmbEent AmbientT~E PORTCOPRESSERCYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 440.00 FT3 440.00 FT3- 440.00 FT3 riEiGl-1[CLVU.7 l..Vl~lrV1VI;1V 1 J %Wt. RS CAS# 100.00 Helium No 7440597 I11-~GEiKL H. 7.7JJA.~1~11;1V-1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -6- 02/06/2007 F RITE AID DRUG STORE 6195 SiteID: 015-021-001893 ~ ~ Inventory Item 0011 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PHOTOGRAPHIC STABILIZER Days On Site KODAK EKTACOLOR PRIMESTABILIZER & REPLINISHER 365 Location within this Facility Unit Map: Grid: PHOTOLAB/CHEMICAL STORAGE AREA CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~mbient ~ Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Avera e 1. D 2~ GAL ,~5 ~.8~0 0 GAL I ~~~ ~ GAL tu~~.~ecLUUa wrir~iv~ivta %Wt. RS CAS# 10.00 Magnesium Nitrate See,G(geQQ No 10377603 1.00 Polyvinylpyrrolidone No 9003398 1.00 SODIUM ALKANE SULFONATE No 0 riAGbiKL 1~JJt5~J1~1t51V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Min ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this Facility Unit Map: Grid: UNDER PHOTO COPIER IN PHOTO AREA CAS# 7783-18-8 LiTAid Waste PRESSURE TA~PeRATURE CONTAINER TYPE qu' T -~ Ambient ~ ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 5.00 GAL 5.00 GAL 5.00 GAL nt~c~htcLVU~ wi~irvlvr,iv 15 %Wt. RS CAS# 40.00 Ammonium Thiosulfate No 7783188 10.00 Sodium Acetate No 127093 nt~,~,tucL t~a5~~ari~lva~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Min -7- 02/06/2007 F RITE AID DRUG STORE 6195 SiteID: 015-021-001893 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PHOTOGRAPHIC STABILIZER Days On Site KODAK FLEXICOLOR ~-'~'~~as~H~ ~-~~~~ (-r~~vAZ ,2!/~[S[~ f ~ LEavisf~ 365 Location within this Facility Unit Map: Grid: PHOTOLAB/CHEMICAL STORAGE AREA CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~mbient ~ Ambient ,PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average L I,~ ~ v GAL 9 Q 5 GAL 5. 0 0 GAL t11~GEiiC1JV U5 1:V1~lYV1Vr;1V1 %Wt. RS CAS# 1.00 Hexamethylenetetramine ~~ No 100970 1.00 ~ Sodium Dodecylbenzene Sulfonate ~~~ No 25155300 1.00 Dipropylene Glycol No 106627 tiAGF~1C1J AS~~~~1~11;1V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Min -s- 02/06/2007 F RITE AID DRUG STORE 6195 SiteID: 015-021-001893 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 06/07/2000 PHOTO LAB OPERATORS ARE NOTIFIED OF THE PRESENCE OF AN EMERGENCY REQUIRING EVACUATION BY VERBAL COMMUNICATION OR WITH THE STORE ALARM SYSTEM IF ONE EXISTS. ALL PHOTO LAB EMPLOYEES WILL EVACUATE IMMEDIATELY FOLLOWING THE WARNING. THERE ARE NO CRITICAL OPERATIONS WHICH WILL BE PERFORMED IN THE PHOTO LAB PRIOR TO EVACUATION. 9 Employee Notif./Evacuation 06/07/2000 PHOTO LAB OPERATORS WILL EVACUATE USING THE CLOSEST ACCESSIBLE EXIT (USUALLY THE FRONT DOOR). THE STORE MAY ALSO PROVIDE A FACILITY MAP, SPECIFIC TO THE STORE, THAT DESIGNATED FIRE EXTIS. PHOTO LAB OPERATORS WILL ENSURE THAT ALL OTHER PHOTO LAB OPERATORS HAVE SAFETY EVACUATED THE BLDG. THE PHOTO LAB MANAGER OR STORE MANAGER WILL BE NOTIFIED OF THE ABSENCE OF ANY PHOTO LAB OPERATORS. Public Notif./Evacuation 06/07/2000 AFTER EVACUATION, PHOTO LAB OPERATORS WILL CONGREGATE IN THE PARKING LOT, A SAFE DISTANCE FROM THE FRONT OF THE STORE. ALTERNATE CONGREGATION POINTS MAY BE SPECIFIED IN THE STORES SITE-SPECIFIC EMERGENCY ACTION PLAN. THE PHOTO LAB MANAGER OR STORE MANAGER WILL BE INFORMED OF PHOTO LAB OPERATORS SAFE EVACUATION. Emergency Medical Plan 07/20/1998 PHOTO LAB OPERATORS WILL NOT PERFORM RESCUE AND/OR MEDICAL PROCEDURES UNLESS THEY ARE SPECIFICALLY TRAINED TO DO SO. -9- 02/06/2007 F RITE AID DRUG STORE 6195 SiteID: 015-021-001893 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 06/07/2000 TO MINIMIZE SPILLS IN THE PHOTO LAB, OPERATORS PRACTICE GOOD HOUSEKEEPING. PHOTO PROCESSING CHEMICAL ARE TYPICALLY STORED IN DELIVERY CONTAINERS AND KEPT IN THE DELIVERY CONTAINERS PRIOR TO USE TO AVOID ACCIDENTAL SPILLS. PHOTO PROCESSING CHEMICALS ARE STORED AWAY FROM HEAVY TRAFFIC AREAS. SPILLS THAT DO OCCUR IN THE PHOTO LAB ARE USUALLY VERY SMALL IN VOLUME AND CAN BE READILY CLEANED UP. 9 Release Containment 06/07/2000 IF A SPILL IS EMITTING STRONG ODORS OR VAPORS, THE LAB OR STORE MANAGER IS IMMEDIATELY NOTIFIED. NOTIFICATION IS MADE PRIOR TO COMMENCING SPILL CLEAN UP PROCEDURES. Clean Up 06/07/2000 IF A SPILL DOES OCCUR, OPERATORS PUT ON PERSONAL PROTECTIVE EQUIPMENT (GLOVES, GOGGLES, APRON) PRIOR TO INITIATING CLEAN UP ACTIVITIES. THE CLEAN UP PROCEDURES VARY DEPENDING ON WHETHER ON SITE SILVER RECOVERY IS PERFORMED IN THE STORE OR IF THE USED PHOTO PROCESSING CHEMICALS ARE TRANSPORTED OFF SITE FOR TREATMENT. v~.iici itcavui~.c Al.l..1VQl..1V11 -10- 02/06/2007 F RITE AID DRUG STORE 6195 SiteID: 015-021-001893 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ r7~lC 1:1011 ncl c.aiu~ _Utility Shut-Offs ,_ r iic rivl.c~.. / t~vait . rval.ci Building Occupancy Level 10/25/2006 22 EMPLOYEES -11- 02/06/2007 ,, ,z P RITE AID DRUG STORE 6195 SiteID: 015-021-001893 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/12/2007 ~ MSDS SHEETS ON FILE AT PHOTO COUNTER. BRIEF SUNIlKARY OF TRAINING PROGRAM: VIDEO AND WRITTEN TESTS. FIRE PREVENTION PLAN IS REVIEWED BY ALL PHOTO LAB OPERATORS UPON INITIAL ASSIGNMENT TO THE PHOTO LAB. IN ADDITION, THE PLAN IS REVIEWED BY.OPERATORS IF THEIR DUTIES UNDER THE.PLAN CHANGE, OR IF ANY CHANGES ARE MADE TO THE PLAN. A WRITTEN COPY OF THIS FIRE PREVENTION PLAN IS KEPT IN THE PHOTO LAB FOR REVIEW BY ALL PHOTO LAB OPERATORS. rayC ~ 11ciu tvt 1'Ul. lalG v~7c nciu tvi r u~.uic vac -12- 02/06/2007 Table A Photoprocessing Chemicals Used in an On-Site Processing Lab Maximum Gluantity Description Product Name pH Water Components Container Size Typically Stored (gallons) (gallons) KODAK FLEXICOLOR Potassium carbonate Film Developer Developer Replenisher 10.1 90 - 95 Pentetic acid, pentasodium salt / 0.75 9 LORR 4- (N-ethyl-N-2-hydroxyethyl) -2- •V/ methylphenylenediamine sulfate Hydroxylamine sulfate Ferric ammonium propylenediaminetetraacetic acid Film Bleach KODAK FLEXICOLOR RA 3.5 60 - 65 Ammonium bromide 0.25 3 gieach Re lenisher NR p Ammonium nitrate Succinic acid Succinic acid, monoammonium salt Ammonium thiocyanate / Film Fixer KODAK FLEXICOLOR RA 7,5 75 - 80 Ammonium thiosulfate r / 1 12 Fixer and Replenisher Sodium bisulfate VVV Ammonium bisulfate KODAK FLEXICOLOR Final Diethylene glycol ~ Film Final Rinse Rinse and Replenisher 7.0 95 - 100 Nonionic surfactant 0.75 9 Magnesium nitrate Isthiazolin derivatives Potassium carbonate Triethanolamine Paper Developer KODAK EKTACOLOR RA 10.7 - 10.8 90 - 95 N,N-diethylhydroxylamine 0.75 15 Develo er Re lenisher p p 4- (N-ethyl-N-2-methanesulfonylaminoethyl) - 2-methylphenylenediamine sesquisulfate monohydrate Potassium hydroxide Ammonium thiosulfate KODAK EKTACOLOR RA Ammonium ferric ethylenediaminetetraacetic / Paper Bleach Fix Bleach Fix and Replenisher 5.3 - 5.5 85 - 90 acid / 1 20 Sodium bisulfate • / V Acetic acid Ammonium sulfite ~F~ Kodak Service & Support HSE Information About On-Site Processing Labs I UNIFIED PROGRAIVI INSPECTION CHECKLIST~`~. ~~->_...... ig~+~;±aa<.,u*--:,.,;.E_. ~.. <.~ r, ..,.~.a..n.r.u ....,~-_.t,r;~a.~~. .ro_..,.. ... ~.,.t~+ ,,...:,.;., . SECTION 1: Business Plan and Inventory Program n • BAKERSFIELD FIRE DEPT >, Prevention Services alts 900 Truxtun Ave., Suite 210 ~srr ~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE INSPECTION TIME / 17`~ ~ tJ~ zoa.~ ~ ! ~~ ! D pZ~ OF ;~o ~2r i.v5 . ADDRESS HONE NO. O OF EMPLOYEES 000 ~c ve 663--0[2/ z~ FACILITY CON CT USINESS ID NUMBER ~s-oz~- vn r~ ~g 3 (~~ Section 1: Business Plan and Inventory Program ~ s `~~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE ~.,/ Lii ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES 4+' ^ VERIFICATION OF LOCATION , Ild' ^ ^ 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 LT ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? YES NO ~nn~---~~~~r/®M - - - - EXPLAIN: _ U~1 t^W ~ .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (861) 326-3978 u~1 s - A Inspector (Please Print) Fire Preventi / 1°' In /Shift of Site/Station # t ~' White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2048 (Rev. 02/05) UNIFIED PROGRAIiA INSPECTION CHECKLIST' SECTION 1: Business Plan and Inventory Program • BAKERSFIELD FIRE DEPT Prevention Services t+ art a Nf~s 900 Truxtun Ave., Suite 210 ~sr~ r Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME l C f FC,(JG.'] 'Z' ~ f7 pz 7 O S'' ~ ~S lac ~ K 4 ADDRESS HONE NO. O OF EMPLOYEES 4000 /~'1 dlC~ u~ . ~ -Dl ? x.2,2. FACILITY CONTACT ' ~ ~ USIN SS ID NUMBER 15-021- Oo ! Fj~l ~ f C ~ / ,,c1 Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION r~ ~_J C V (c=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIr18SS PLAN CONTACT INFORMATION ACCURATE ~ ~ NW ~~`~- N -G~ ^ VISIBLE ADDRESS L9' ^ CORRECT OCCUPANCY -/ U3" VERIFICATION OF INVENTORY MATERIALS ~ t ~1 N O X-O vL ~-+~ G.~2~f H (~ ~•4 'fi'r- i~ v ~ rJ Q / A T~ G, ~G r ~ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PRO EDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? L~TYtS ^ NO EXPLAIN: W~fY~ l~Da~~C_~/..~G~ - ---- - .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALLUS AT (661) 326-3979 «¢ ~l (3G2~tJ 9'- ,A Inspector (Please Print) Fire Prevention / is' In /Shift of Site/Station # usiness Site/Sch ite sponsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink - Busin/es~ opE" y FD2048 (Rev. 02/05) :/