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+ KERN CHARTER SERVICE INC ____________________________ SitelD: 015-021-001928 +
Manager SHANE ELLIS BusPhone: (661) 834-6870
Location: 410 E PLANZ RD Map 124 CommHaz Moderate
City BAKERSFIELD Grid: 17A FacUnits: 1 AOV:
CommCode: BFD STA 05 SIC Code:8299
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
RANDY GRIFFITH / OWNER SHANE ELLIS / MANAGER
Business Phone: (661) 834-6870x Business Phone: (661) 834-6870x
24-Hour Phone (661) 577-2047x 24-Hour Phone (661) 577-2047x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire ImmHlth DelHlth
Contact Phone: (661) 834-6870x
MailAddr: 410 E PLANZ RD State: CA
City BAKERSFIELD Zip--_-~` f~~~A~
Owner RANDY GRIFFITH Phone: (661) 763-4773x
Address 1050 WOOD ST State: CA
City TAFT Zip 93268
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives:
PROG A - HAZMAT V D
PROG T - ABOVEGROUND STORAGE TANK ~~
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Based on my inquiry of those individuals
responsible for obtaining the information, I certify
under penalty of iaw that I have personally
examined and am familiar with the information
submitted and believe the information is true,
accurate, and complete.
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-1- 03/07/2006
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UNIFIED PROGRAM INSPECTION CHECKLIST
Bakersfield Fire Dept.
Environmental Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel: (661)_326-3979
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SECTION 1 Business .Plan and Inventory Program
•
Section 1: Business Plan and Inventory Program
Routine O Combined D Joint Agency OMulti-Agency O Complaint O Re-inspection
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FACILITY NAME / INSPECTION DATE INSPECTION TIME
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ADDRESS PHONE No. No. of Employees
FACILITYCOI~TACT /~ n L~ , l Business ID Number
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• QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~F)6'I ~ 328-3979
- -- - -------~~--/-v1~-~-~-- ~~--~---- ---- ----- --------------- -- --- :_ _ . _
I Spector (PleasA Print) ~ Fire Prevention 1st-In/Shik of Site
While • Environmental Services Yellow -Staten Copy
Business Site Responsible Pa (Please Print) ~
Pink -Business Copy
ANY HAZARDOUS WASTE ON SITE?: ^ YES ~NO
UNIFIED PROGRAM .~~ISPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel:. (661)326-3979
F.4CILITV NAME ~ INSP TION DATE - i INSPECTION TIM
- - - - ---------------- - - --- -- -------
ADDRESS ~ i PHONE No. 1 No. of Employees
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F.4CILITYCONTACT Business ID Number
R-U ~ ~ ~ 15-021-(j;;~ Z
Section 1: Business Plan and Inventory Pn~gram
Routine ^ Combined ^ Joint Agency ^MuIti-Agency ^ Complaint ^ Re-inspection
C V \V=Vioatonn~~ OPERATION COMMENTS
^ APPROPRIATE PERMIT ON HAND
E~J ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
----~---- r--------- ---------- ------ ---~~------------ -- -- ----
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^ VISIBLE ADDRESS
/
,
U7 ^ CORRECT OCCUPANCY
QI ^
^ VERIFICATION OF INVENTORY MATERIALS
VERIFICATION OF QUANTITIES O
^ V
ERIFICATION OF LOCATION
`Y ^ PROPER SEGREGATION OF MATERIAL - -
i~ ^ VERIFICATION OF MSDS AVAILABILITVE
It1d ^ VERIFICATION OF HAT MAT TRAINING -
RY ^
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
- - - - ------- --- -------- -------------
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!~J ^ EMERGENCY PROCEDURES ADEQUATE ~
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CONTAINERS PROPERLY LABELED i
- ------- ----- --------------- ---
U Ll F10USEKEEPING
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^ FIRE PROTECTION -- ----- -------- --- ---------.--
- - ----------- --------f ---- ------------ ------------------
^ SITE DIAGRAM ADEQUATE & ON HAND I
ANY HAZARDOUS WASTE ON SITE?: ^ YES ^ NO ~ ~~
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EXPLAIN: __ f/T~' ~-~~ /C1 a y ,~ lr' '~.~r~/~ ~- 7C~U~
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QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (881) 328-3979
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Business Site R ponsible Party
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White - Environmental Services Yellow - Slatbn Copy Pink -Business Copy i t