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Home My WebLink AboutBUSINESS PLAN UNIFIED PROGRAM INSPECTION CHECKLIST.: SECTION 1: Eusiness Plan and Inventory Program • • Prevention Services e ERs F , „ 900 Truxtun Ave., Suite 210 - -FIRE Bakersfield, CA 93301 ARTM r- Tel.: (661) 326-3979 Fax: (661) 872-2171 " FACILITY NAME INSPECTION DATE INSPECTION TIME Lo ~~L ~ ,~, z~P i~ - ~ - ~ 3 ZO ADDRESS PHONE NO. NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 15-021- oo3(j3~ Section 1: Business Plan and Inventory Program il/ ~ ~~l i ROUTINE ^ COMBINED ^ JOINT.AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=compliance OPERATION V=Violation COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSIn@SS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ VERIFICATION OF INVENTORY MATERIALS ^ ^ VERIFICATION OF QUANTITIES ~ ^ ^ VERIFICATION OF LOCATION ' ^ ^. PROPER SEGREGATION OF MATERIAL 1 ~/ ~^ ^ VERIFICATION OF MSDS AVAILABILITY- ^ ^ VERIFICATION OF HAZ MAT TRAINING ~~~ S ~ P ~ 1 ^ ^ .VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^ ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? 'DYES ^ NO EXPLAIN: ~ ~`S ~~ ~ ~ L- os QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~ ~~ ~a~~ ~~~~~~ ~ ~ ~ Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # Business Site /Responsible Party (Please Print) .White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ~al~ersfield Fire Depg.~ ~! ?~O UNIFIE® PR~G0~11A INSPECTI®N CFIECFCL.IS°T ~ Enironmentai services ~F _ .. w ~ .~ .:;~~.~~- ,. , .g 1715 Chester Ave SEC`TI®RI 1 Business Plan and Inventory Program Bakersfield, CA 93301 2Z Tel: (661)326-3979 FACILITY NAME ~ INSPECTION DAT INSPECTION TIME ii -------------~------__----------------------------------- _--......__...-_.._------- - ------~- ----- -----p y-______ ADDRESS PHONE No. No. of Em to ees ~w G, t ~~ FACILITYCONTACT Business ID Number 15-021 ~i,J "' Section 1: Business Plan and Inventory Program Jv " ^ Routine ,~ombined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V (c=Compliance) OPERATION V=Violation COMflAEIdTS 0~~~~ C n , ~ V ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ ~ VERIFICATION OF INVENTORY MATERIALS ~ ~~ dt~ _. ~ f / Q~,~ ^ ^ VERIFICATION OF QUANTITIES 1 ~O ~L 2~~ ~.,~ ~ Z.~l ^ ^ VERIFICATION OF LOCATION t („j S14~ U.1'CS-~--- - -- -- ~^~~ OC- 5~ -- -- _. . ---_ _ - --_ _._ ------_ - - ^ ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITYE ~ - ~ ~ ~ 1 ---- --- - ------- ----- ---------- - --- - --- ---- - -- - - - - - - _ - -- -- _ - - --- _ __ ------ ---------__... -- - - - - ^ ^ VERIFICATION OF HAT MAT TRAINING d~/ 1lr' r'~ l~ ---------- -----------------------------...._...__...___..._- - --___------_ ----- ----- - v_ ---.___._..------------------ - -- ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~~ ' // ^ ^ EMERGENCY PROCEDURES ADEQUATE ~' ^ ^ ~;ONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^ FIRE PROTECTION T ~ ~ ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WAST~E,O~N SITE: t'~YES ^ NO EXPLAIN: ~'~S ! ~- ~r L- QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~6F)'I ~ 326-3979 (~ ~ n1 ~ S Inspector (Please Print) Fire Prevention 1st-In/Shift of Site White -Environmental Services Business Site R onsible Party (Please Print) Yellow -Station Copy Pink -Business Copy rn N O ;~ CITY OF 13AKERSFIELD - . B E R s P ', °; OFFICE OF ENVIRONMENTAL SERVICES F/RB ' AIirTM T 1715 Chester Ave., CA 93301 (661) 326-3979 ; HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one 7orm per material per building or area) ~( J41 NEW ~ ADD ~ DELETE ^ REVISE ~0 Page _ of -_ ._.-.-------~-_-- ---_- ' I. FACILITY INFORMATION I BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 CAD PCZ ~cJ i U R~~P.a-r 2 `` ~ CHEMICAL LOCATION ~ r ~~ ~ S t 9 L: (~' ~ (~(y 201 CONFIDENT AL (EPCRA) ^ Yes ^ No 202 ----- 1 i FACILITY ID # ~ -_T ~ I ~ ~- -'' ~ ~ ~ ~ - ~ tl MAP #.(opuonaQ ~ -~~ ~ - ~ ~ 203 ~ GRID # (ophonan ~- - ~ ~ ~~---------- :. l. -- f - 20a •I• L, ~ - --- -- - --- - --~ I ' II. CiiEMICAL INFORMATION 205 ~ TRADE SECRET ^ Yes ^ No 206 CHEMICAL NAME ~~ -~-~ O~ ~ If Subject to EPCRA, refer to instructions ' ----- ----~-_..-- -- - .._-. 207 . -.. .--------------------...----- ----- COMMON NAME EHS' ^ Yes ^ No 206 CAS # 209 •If EHS is'Ya,' all amo°nts lxlow must be in lbs. ' FIRE CODE HAZARD CLASSES (Complete if requested by local fre chief 210 ~'~ -~- ~ ~ ~ ~~ ~-~-~--~--- 212 CURIES TYPE ^ p PURE m MIXTURE ^ p~,w WAS-_ L- : r'~-,UIOACTIVE ^ Yes ^ No 213 ~ /' PHYSICAL STATE ~ ^ s SOLID L~`I-I.IOUID ^ g GAS Ztq LARGEST CONTAINER S~ 215 FED HAZARD CATEGORIES ~-FIRE ^ 2 REACTIVE ^ 3 PRESS iRE f~:ELEi.SE 11 :.4~:U-~E HEALTH ^ 5 CHRONIC HEALTH (Check all that apply) 216 I ANNUAL WASTE 217 ;d4XIML'M ) 218 AVERAGE 219 ~ STATE WASTE CODE ~ ~ ~ 220 AMOUNT DAILY AMOUNT (~ ( DAILY AMOUNT ~ I UNITS' ~ GAL ^ cf CU FT ^ Ib LBS ^ In TONS 221 i DAYS ON SITE 222 ~ ' If EHS, amount must be in lbs. ~ STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIC/NONMETALLIC DRUfwI ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 (Check all that apply) i ^ b UNDERGROUND TANK ^ f CAN• ~, j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN i ~ STEEL DRUM ^ h SILO ^ I CYLINDER ^ p TANK WAGON ' STORAGE PRESSURE ~ a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT t ----------- . ...-- - - -- _. .. - .... - .. _.. _.-.. - . _ ... _.. --------- 224 STORAGE TEMPERATURE I~ a AMBIENT ^ as ABOVE AMBIENT ^ b3 BELOW AMBIENT ^ c CRYOGENIC 225 %NVT HA7ARDOUS COMPONENT ... ,,, EHS ~ CAS # 1 ' 226 + 227 ~ ^ Yes ^ No 228 229 ---------------- -- - --- - - - i i ~ i 2 230 231 i ^ Yes ^ No 232 233 I__.__.i_.._..__._- --~--- ~ ----- - -- -- - - - , 3 234 Ii 235 ^ Yes ^ No 236 237 ~ -- ~ --------__ ------ L.-....-_ _. 24t 4 i 238 239 i ^ Yes ^ No 240 i 5 ' 242 ~ -. . I 2.13 i ^ Yes -' - ~ - ^ No 244 2a5 III. SIGNATURE I _ _ PRINT NAME 8 TITLE OF AUTHORIZElS COMPANY REPRESENTATIVE SIGNATURE DATE 246 UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd CITY OIL L3AKERSFIELD . - B E R s P' D; OFFICE OF ENVIRONMENTAL SERV[CES ARTM T 1715 Chester Ave., CA 93301 (661) 326-3979 _' • './r.~y Ai ~ . A .y,r.y' i4M1 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one loan per material per building or area) /~IEW ^ ADD ^ DELETE ^ REVISE 200 Page _ of _ ' I. FACILITY INFORMATION _________ BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) ~ 3 - LvPC~ A-~'rv 6~~.P~.z CHEMICAL LOCATION '~ S t ~` SC-I-v P ~ 20 CONFIDENTIOAL (EPCRA) ^ Yes ^ No 202 ------ --~ _..-.I . _..__ ; _.___ -ii MAP q o ~trona -_ _ 203 GRID # o bona - _ - ------------ ---- 20a - ~~ FACILITY ID # !.~ i t ~ •: , i , (p ~ Q (p ~ ~ ~.:1"~ ~ ~ ~ ~ i ,,,v I , ~ 11. Ci~EMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^ Yes ^ No 206 I! Subjed to EPCRA, refer to instructions ~~ GG z ------- ---_.____ -. 207 . -. _------------------------- - ~' COMMON NAME EHS' _ ^ Yes ^ No 208 CAS # 209 •I(EHS is'Ya.' all amounts below must be iA Ibs. ' i FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief 2t0 -----------------------__...-....... _ -_-~. ....- - ....... c-=. - --- --- -... TYPE ^ p PURE '~~ MIXTURE ^ w WA„,~ .. r',~,!~IOACTIVE ^ Yes ^ No 212 CURIES 2i3 PHYSICAL STATE ^ s SOLID ^ I LIOUID ,~g GAS 214 LARGEST CONTAINER 26'7 215 j FED HAZARD CATEGORIES ^ 1 FIRE ^ 2 REACTIVE bL~" PRESS .RE F.ELE,;SE I_ A 1U-'E HEALTH ^ 5 CHRONIC HEALTH 216 (Check al! that apply) ANNUAL WASTE 217 ;v14XIMUAt 218 AVERAGE 219 j STATE WASTE CODE 220 ' AMOUNT DAILY AMOUNT ~~ DAILY AtvtOUNT STORAGE CONTAINER (Check a!1 that apply) STORAGE PRESSURE STORAGE TEMPERATURE UNITS' ^ ga GAL ~d CU FT ^ Ib LBS ^ to TONS ' If EHS, amount must be in Ibs. ^ a ABOVEGROUND TANK ^ e PLASTIC/NONMETALLIC DRUfvI ^ i FIBER DRUM ^ m GLASS BOTTLE ^ b UNDERGROUND TANK ^ f CAN u j BAG ^ n PLASTIC BOTTLE ^ c TANK INSIDE BUILDING ^ g CARBOY kk BOX ^ ^ o TOTE BIN ^ d STEEL DRUM ^ h SILO , , L`~IiYLINDER ^ p TANK WAGON ^ a AMBIENT ~aa ABOVE AMBIENT ^ ba BELOW A MBIENT 221 I DAYS ON SITE 222 ^ q RAIL CAR 223 ^ r .OTHER 224 /~3_AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 .. . i 5 i 242 243 ! ^ Yes ^ No 244 245 III. SIGNATURE - i I PRINT NAME 8 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 J - _ ---_-- - _-_ _ .. -------- -- ~ - __ _------ 41, r ~~ -- - _ UPCF (7/99) ~ S:\CUPAFORMS\OES2731.TV4.wpd ~., D E R S R! D~ P/RB ~RrM r ..,Y...,.~~. ~ ~:...,_ CITY OF I3AkERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION W ^ ADD ~ DELETE ^ REVISE 200 I. FACILITY I~IFORMATION ' BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) C1J PCB ,~r,~ ~,f~/a-t2 CHEMICAL LOCATION _ l/JS rQL ~~ _ C I i( MAP q (opibna~ 203 .. ,.. ;., il. CrlEMiCAL INFORMATION • CHEMICAL NAME ~~~ ~ ~- (T L~~ COMMON NAME i CAS # FIRE CODE HAZARD CLASSES (Complete if requested by local fire chje~ ."~? _ ~ (one loan per material per building or area) ---`Page--- -- ol -------- I _.-----------~---- 3 201 CHEMICAL LOCATION CONFIDENTIAL (EPCRA) GRID # (optional ^ Yes ^ No 202 205 TRADE SECRET ^Yes ^ No 206 I! Subject to EPCRA. refer to instructions 207 EHS' ^Yes ^ No 208 209 •If EHS is'Yes,' all at°ounts Dclow must tz io lbs. 210 _.. .. _. _. _ .... -- _ -_ TYPE ~URE ^ m MIXTURE ^ w WAS-= .. r.~.L'IOACTIVc ^Yes ^ No CURIES 212 213 PHYSICAL STATE ^ s SOLID ^ 1 LIQUID ~ GAS 2,a LARGEST CONTAINER ~ /~ 1 215 FED HAZARD CATEGORIES - (Check all that apply) .FIRE ^ 2 REACTIVE ~ PRESS iRE F.ELE~:SE I. •: > :U`E HEALTH ^ 5 CHRONIC , HEALTH 216 ' ANNUAL WASTE AMOUNT 217 ,v14XIMUhI 218 GAILY AMOUNT ~ ~ Q AVERAGE TT DAILY AMOUNT ~ ~ V 219 ~ STATE WASTE CODE i 220 UNITS' ^ 9a GAL ~ d CU FT ^ Ib LBS ^ to TONS 221 i DAYS ON SITE 222 C ' If EHS, amount must be in lbs. j STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 (Check all that apply) ' ~ ^ b UNDERGROUND TANK ^ f CAN u j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN I ^ d STEEL DRUM ^ h SILO I CYLINDER ^ p TANK WAGON - -----'--' STORAGE PRESSURE ----.. __ .... ^ a AMBIENT ~aa ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE '[~ a gMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 ~ %Wi'.. , ', - HAZARDOUS COMPONENT EHS j % . CAS # 1 I 226 i 227 ~ ^Yes ^ No 228 229 i 2 230 231 ^Yes ^ No 232 233 i - 3 _, 234 i i 235 ^Yes ^ No 236 237 :. ... -......-__. _.______._.. -._._._--.4- 4 I 238 I i. ~ -_....--.... 239 i ~ ^Yes ^ No 240 i 241 ----i----°---_ ... .. i. -- ----- - ------------------ 5 I 242 ----._.._.__~~ _- ----...-.---.....-...._........_._._. _.. _... -._ ............ .. 2a3 I ^Yes ^ No 2aa -._. -.. . ... _ - _ .....---... _;._....---- _ _ _ ------- _-------- 2a6 --- i III. SIGNATURE I ~ I PRINT NAME & TITLE OF AU THORIZEd COMPANY REPRESENTATIVE ~~ ~ ~ ~ ~ ~ ~ ~ SIGNATURE ~ ~ ~ -~ DATE 2a6 ~ i Gf/°Z/ / UPCF (7/99) S:ICUPAFORMS10ES2731.TV4.wpd ' , ~~ _ CITY OIL 13AKERSFIELD ~....,~, i °- E R S F ` °, OFFICE OF ENVIRONMENTAL SERVICES AR M' t 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one loan per material per building or area) LCf10EW ^ ADD ^ DELETE ^ REVISE 200 Page _, of _ ' I. FACILITY 1~IFARMATION _ _ ________ _ _ ______ -BUSINESS NAME (Same as FACILITY NAME"or OBA - Doing Business As) _ ^3 Z.rJ f~~-~ ~~ (?~,~A-r2 ..----------------- CHEMICAL LOCATION ~ 201 CHEtAICAL LOCATION ^ Yes ' /mss t~L S'~ (~ CONFIDENTIAL (EPCRA) ^ No 202 tt'' --- FACILITY ID # ~ fi, ( (- I :I -!-- ' 1~ MAP.# (ophonaq 203 GRID # (opfronan - -~---- T--- ---- 204 I y II. CiiEMiCAL INFORMATION I CHEMICAL NAME 205 TRADE SECRET ^ Yes ^ No 206 ~jr ~~ I! Subject to EPCRA. refer to instructions 207 COMMON NAME EHS' ^ Yes ^ No 208 CAS # 209 •It EHS is'Yes,• aU amougts Ixlow must be iq lbs. ' FIRE CODE HAZARD CLASSES (Complete it requested by local fire chief) 210 TYPE'PURE ~ " - ~^ m MIXTURE ^ w WASTE " . ~ ~ c ^-No " - - 212 CURIES 2i3 .. n-,!IOACTIV~ ^ Yes PHYSICAL STATE ^ s SOLID ^ I LIOUID ~.{;;,g 2,q LARGEST CONTAINER. 'Z~~ 275 FED HAZARD CATEGORIES ^ 1 FIREREACTIVE ~ PRESS JRE kELEI,SE i! A :U--E HEALTH ^ 5 CHRONIC HEALTH 216 (Check all that apply) i-- ---------_... ._..... ... ...- ~ - - ~ - -- -- ---~-------- _-- ' ANNUAL WASTE 217 M4XIMUM 218 A.VL--RAGE 2~ f 219 ! STATE WASTE CODE 220 AMOUNT DAILY AMOUNT Z ~( DAILY AMOUNT l I UNITS' ^ ga GAL ~i CU rT ^ Ib LBS ^ to TONS 221 ' DAYS ON SITE 222 ' If EHS, amount must be in lbs. j I STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIC/NONMETALLIC DRUtvI ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 i (Check all that apply) ^ b UNDERGROUND TANK ^ f CAN v j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN I ^ d STEEL DRUM ^ h SILO I CYLINDER ^ p TANK WAGON STORAGE PRESSURE ^ a AMBIENT ,~aa ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE G~AMBIENT ^ as ABOVE AMBIENT ^ b3 BELOW AMBIENT ^ c CRYOGENIC 225 ~. %VVT - HAZP,R000S COMPONENT EHS ! ~ " CAS # ~ -"------__._.._...___ ____....- -- ----- ------ . -- -- . __ _ _ ._ . --._.. _. _ _..._.__ .._o - _. - ------ - 1 i 226 ~ 227 ~ Yes ^ No 228 229 -- -_.~.--------- -------i---- ~ - ----------"----------~. ' 2 ~, 230 231 i ^ Yes ^ No 232 233 i i I 3 234 I 235 ^ Yes ^ No 236 237 I i --- - _---------- - -- - ---- 4 i 238 239 ~ ~ 241 ^ Yes ^ No 240 5 i 242 243 ! 245 ^ Yes ^ No 244 III. SIGNATURE ' ~ PRINT tJA1v1E li TITLE OF AUTHORIZED-COMPANY REPRESENTATIVE ~ " ~ - ~ ~~ -~ ~~ ~ -~ SIGNATURE ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ^ DATE 246 ' L _ _ ..__ __--- ------ --- -- - - ----~--~~ ~~~~- UPCF (7199) S:\CUPAFORMS10ES2731.TV4.wpd