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HomeMy WebLinkAboutBUSINESS PLAN 6/21/2007i UNIFIED PROGRAM INSPECTION CIiECKLIST `; .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT a p Prevention Services ~-~RS 900 Truxtun Ave., Suite 210 ~trr t Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME / NSPECTION DATE INSPECTION TIME ADDRESS ~C~ 0 1 `~ ~ ~~ HONE NO. 3 z 7-~6 Yb O OF EMPLOYEES ~~ FACILITY CONTACT " USINESS ID NUMBER 15-021- v O ~ 1 ~ Z , A ,.,~ •^ A ,, ,,,.. ~ Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND Gl' ^ BUSIrtASS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ttQ ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS Ili ^ . VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~ID JUN 2 2 2007 l~ ® ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ~ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND P OCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING + . ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES Cy" NO QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (881) 328-397 ~~.I~ ~~t I/ ? ~ ~ Inspector (Please.l~rint) Fire Prevention / 1" In /Shift of SRe/Station It st ess it School Sife Responsible Pa lease Print) White -Prevention Services Yellow -Station Copy Pink - Buainese Copy FD21148 (Rev. /l¢!QS) Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST;~~ B E R s F , D 90o Truxtun Ave., Suite 210 _- - _--- ~.~ _ w- _._ _ ___ ___,__ __ _ _ _ _ ----- - FARE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program "R'M ' Tel.: (661) 326-3979 • ~ Fax: (661) 872-2171 FACILITY NAME INSPECTION DA~T/E INSPECTION TIME ADDRESS ~ l`t~L Sc`' ~ PHONE NO. ~Z~~86~:G NO OF EMPLOYEES ' ~ ~ FACILITY CONTACT ~j.2C,~N t ~' BUSINESS ID NUMBER 15-021- ~~/ 7.Z Section 1: Business Plan-and lnventary Program. ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=compliance` OPERATION V=Violation / COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIC1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS '' I 1 ~ ~( ~ ~/ (`{ ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ 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 ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Prin Fire Prevention / 1s` In /Shift of Site/Station # Business Site /Responsible Party (Please Print) ^ YES ~NO White -Prevention Services Yellow -Station Copy Pink -Business Copy - FD 2155 (Rev. 09/05 ~~ + LOG CABIN FLORIST =_____=~___________________________ SitelD: 015-021-002172 + Manager BusPhone: (661) 327-8646. Location: 800 19TH ST Map 103 CommHaz Minimal City BAKERSFIELD Grid: 30A FacUnits: 1 AOV: CommCode: BFD STA Ol SIC Code: EPA Numb: DunnBrad: Emergency Contact / 't'itle Emergency Contact / Title JERRY BECKWITH / VICE~PRESIDENT DAWN BAUMGARTEN / PRESIDENT Business Phone: (661) 32,T-8646x Business Phone: (661) 327-8646x 24-Hour Phone (661) 32'3'-6781x 24-Hour Phone (661) 631-9515x Pager Phone ( ) - x Pager Phone (~(~ ~ ) gyp` - ~~--j ( x Hazmat Hazards: Fire Press ImmHlth Contact JERRY BECKWITH Phone: (661) 327-8646x MailAddr: 800 19TH ST State: CA~ City BAKERSFIELD Zip 93301 Owner LOG CABIN FLORIST Phone: (661) 327-8646x Address 800 19TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: ~ RSs: No ParcelNo: ~ Emergency Directives: ~ PROG A - HAZMAT MAC 0 8 2006 Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. -~ `E~ -1- 02/27/2006 ,r' LOG CABIN FLORIST SiteID: 015-021-002172 Manager ~c~w,~r m,~~,r'©~i,~v~~,V- BusPhone: (661) 327-8646 Location:~800.19TH ST Map 103 CommHaz Minimal City BAKERSFIELD ~~~~~~ Grid: 30A FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title JERRY BECKWITH / VICE PRESIDENT DAWN BAUMGARTEN / PRESIDENT Business Phone: (661). 327-8646x Business Phone: (661) 327-8646x 24-Hour Phone (661) 323-6781x 24-Hour Phone (661) 631-9515x Pager Phone ( ) - x Pager Phone (661) 301-1571x Hazmat Hazards: Fire Press ImmHlth Contact JERRY BECKWITH Phone: (661) 327-8646x MailAddr: 800 19TH ST State: CA City BAKERSFIELD Zip 93301 Owner LOG CABIN FLORIST Phone: (661) 327-8646x Address 800 19TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT ~N~p ~ ' ~ ~ i3ased on my inquiry of those individuals ~~ ,~~~~ responsible for obtaining the information, 1 certify under penalty of !aw that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. a-~- ~~ o-~ Signature ~ Date -1- 02/02/2007 F LOG CABIN FLORIST SiteID: 015-021-002172 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP HELIUM F P IH G 219.00 FT3 Min -2- 02/02/2007 -3- 02/02/2007 F LOG CABIN FLORIST SiteID: 015-021-002172 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: NE CRNR OF SHOP CAS# 7440-59-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 219.00 FT3 219.00 FT3 219.00 FT3 ru-ic~tucyvua ~.vt~irvlv~iv l ~ oWt. RS CAS# 100.00 Helium No 7440597 tLHGKKL HJ 5~J51~1L'LV1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -4- 02/02/2007 n ; F LOG CABIN FLORIST SiteID: 015-021-002172 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 01/23/2001 ~ DELIVERED AND CHAINED IN PLACE BY BARNES WELDING SUPPLY EMPLOYEE. VALVE CHECKED DAILY BY EMPLOYEES. IF FOUND LEAKING WE WOULD CONTACT OUR SUPPLIER AND HAVE IT REPLACED. Employee Notif./Evacuation VERBAL. 01/2,3/2001 Public Notif./Evacuation 03/08/2006 JERRY BECKWITH - PRESIDENT TERRY BECKWICH - SECTY/TREASURER DAWNN BAUMGARTEN - PRESIDENT Emergency Medical Plan 01/23/2001 TAKE EMPLOYEES TO CLOSEST MEDICAL FACILITY. -5- 02/02/2007 F LOG CABIN FLORIST SiteID: 015-021-002172 ~ ~ Mitigation/Prevent/Abatemt Overallo5ite ~ ~ Release Prevention 01/23/2001 ~ HELIUM TANKS ARE HANDLED PROPERLY/CHAINED IN PLACE AND REMOVED BY BARNES WELDING SUPPLY EMPLOYEE. TANKS ARE CHECKED AT BARNES AT TIME OF REFILLING. Release Containment 01/23/2001 N/A. Clean Up 01/23/2001 WE WOULD CONTACT BARNES WELDING SUPPLY IF WE HAD A PROBLEM WITH THE HELIUM TANKS. Vl.i1CL J.CCb"VI.LLC:C tiC:l.lVdl.1(>!1 -6- 02/02/2007 F LOG CABIN FLORIST SiteID: 015-021-002172 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JC l.:1d1 r3dGdl U.S' Utility Shut-Offs 02/02/2007 A) GAS - W END OF BLDG OUTSIDE MAIN WALL B) ELECTRICAL - W END OF BLDG INSIDE STORAGE RM C) WATER - N SIDE OF PARKING LOT SP 3 D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water. 02/02/2007 SPRINKLER SYSTEM -- - Building Occupancy Level 03/08/2006 25 EMPLOYEES -7- 02/02/2007 a F LOG CABIN FLORIST SiteID: 015-021-002172 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/02/2007 ~ MSDS SHEETS IN COMPANY SAFETY MANUAL AND POSTED. BRIEF SUMMARY OF TRAINING PROGRAM: APPROXIMATELY EVERY 2-3 WEEKS WE HOLD A MEETING WITH ALL EMPLOYEES ON AREAS THAT MIGHT BE A DANGER FOR EMPLOYEES. THE FORM IS SIGNED BY EMPLOYEES AND INCLUDED IN OUR COMPANY SAFETY AND HEALTH PROGRAM MANUAL. POSTERS AND FORMS ARE KEPT CURRENT BY MANAGEMENT. rayc c. 11C1U 1VL lUI, ULC V.7-C 1ZC1ll LUL I'ULULC U.SS~ -8- 02/02/2007 UNIFIED PROGRAAA INSPECTION CHECKLIST ,<,~, SECTION 1 Business .Plan and Inventory Program • FACILITY N ME ~G- Cl~~cn1 ~c~~+~-~ __ -.-._._.-_--. -_-. -._... - -- . __ - _ .. ADDRESS QQ~~ ~~/ ~j FACILITYCONTACT `D.l~wr~ g~vn~G~;~-c~~ Bakersfield dire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 ' Tel: (661) 326-39'~C _j INSPEC ION DAT INSPECTION TIME PHONE No. No. of Employees 3z~ 866-- -- 23--- -_ _.. Business ID Nuumber 15-021-~Zt2Z Section 1: Business Plan end Inventory Program ,O'F~outine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection • ANY HAZARDOUS WASTE ON SITE?: OYES ^ NO EXPLAIN: • QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT 661 326-3979 _ S 5 ~o ~.J -- --- ----- -p- --- - ------- --- _ ------------ .---- - --- Inspector (Please Print) t Fire Prevention 1st-InlShifl of Site While -Environmental Services yellow -Station Copy r-~--~ l ~. -N i~----- Busmess Site Responsible Party (Please Print) g Pink -Business Copy ~~V•• ~'I ~ ° OFFICE OF ENV1R()NM NTA LSER V CES NT NOV ~~` ~~ '~ UNIFIED PROGRAM INSPECTION CNECKI.[ST y ~a ;ati~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 9330! FACILITY NAME ~~ ~ ~''^ ADDRESS ~~~ ~ ~ ~ ~ FACILITY CONTACT U w e a cc r,n ~ t v. INSPECTION TIME .~`-.~.:~ INSPECTION DATE //- l ~ D.~ _ PHONE NO. ~~~' fl~~~ BUSINESS ID NO. l 5-210- ~-/'/ 2 NUMBER OF EMPLOYEES / ~ Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^Mul1i-Agency ^ Complaint Q Re-inspection OPERATION C V COMMENTS Appropriate permit on hand i Business plan contact information accurate Visible address l ~~~? ~} Q Correct occupancy Verification of inventory materials Verification of quantities Verification of {ocation 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 p'~ Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: a Yes ~No Explain: Questions regarding this inspection? Please call ua at (661) 326-3979 Whitr -Env. Svcs. Yellow -Station Copy Pink -Business Copy Business Site Responsible Party Inspector: ~ J ~ ~~..~ 't`-~ LOG eABIN FLORIST SiteID: 015-021-002172 Manager DAWN BAUMGARTEN Location: 800 19TH ST City BAKERSFIELD BusPhone: (661) 327-8646 Map 103 CommHaz Minimal Grid: 30A FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title JERRY BECKWITH / VICE PRESIDENT DAWN BAUMGARTEN / PRESIDENT Business Phone: (661) 327-8646x Business Phone: (661) 327-8646x 24-Hour Phone (661) 323-6781x 24-Hour Phone (661) 631-9515x Pager Phone ( ) - x Pager Phone (661) 301-1571x Hazmat Hazards: Fire Press ImmHlth Contact JERRY BECKWITH Phone: (661) 327-8646x MailAddr: 800 19TH ST State: CA City BAKERSFIELD Zip 93301 Owner LOG CABIN FLORIST Phone: (661) 327-8646x Address 800 19TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~N'~'a ~ ~ ~ ~ zooT Fused on my inquiry of those individuals resF,onw;t7ie for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and `a^lieve the information is true, accurate, and complete. g ature ~ U -1- 07/12/2007 F LOG CABIN FLORIST SiteID: 015-021-002172 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP HELIUM F P IH G 219.00 FT3 Min -2- 07/12/2007 -3- 07/12/2007 it ~ F LOG CABIN FLORIST ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit NE CRNR OF SHOP Days On Site 365 Map: Grid: CAS# 7440-59-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 219.00 FT3 219.00 FT3 219.00 FT3 t~l~~tiru~uua ~vl~irulVl;iV 15 %Wt. RS CAS# 100.00 Helium No 7440597 riL~GHKL H. 7JL"5J1~1L'1Vla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min SiteID: 015-021-002172 ~ Facility Unit: Fixed Containers at Site ~ -4- 07/12/2007 F LOG CABIN FLORIST SiteID: 015-021-002172 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 01/23/2001 ~ DELIVERED AND CHAINED IN PLACE BY BARNES WELDING SUPPLY EMPLOYEE. VALVE CHECKED DAILY BY EMPLOYEES. IF FOUND LEAKING WE WOULD CONTACT OUR SUPPLIER AND HAVE IT REPLACED. Employee Notif./Evacuation 01/23/2001 VERBAL. Public Notif./Evacuation 03/08/2006 JERRY BECKWITH - CCU -~~~1 ~ TERRY BECKWICH - SECTY/TREASURER DAWN$J BAUMGARTEN - PRESIDENT Emergency Medical Plan 01/23/2001 TAKE EMPLOYEES TO CLOSEST MEDICAL FACILITY. -5- 07/12/2007 F LOG CABIN FLORIST SiteID: 015-021-002172 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 01/23/2001 ~ HELIUM TANKS ARE HANDLED PROPERLY/CHAINED IN PLACE AND REMOVED BY BARNES WELDING SUPPLY EMPLOYEE. TANKS ARE CHECKED AT BARNES AT TIME OF REFILLING. Release Containment N/A. 01/23/2001 Clean Up 01/23/2001 WE WOULD CONTACT BARNES WELDING SUPPLY IF WE HAD A PROBLEM WITH THE HELIUM TANKS. ~,_ V 1.1161 11C w7VUl l.G t]1. 1.1V0.l.l Vll -6- 07/12/2007 F LOG CABIN FLORIST SiteID: 015-021-002172 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~1C C:1d1 I1dGdI U.7~ Utility Shut-Offs A) GAS - W END OF BLDG OUTSIDE MAIN WALL B) ELECTRICAL - W END OF BLDG INSIDE STORAGE RM C) WATER - N SIDE OF PARKING LOT SP 3 D) SPECIAL - NONE E) LOCK BOX - NO 02/02/2007 Fire Protec./Avail. Water 02/02/2007 SPRINKLER SYSTEM Building Occupancy Level 03/08/2006 25 EMPLOYEES -7- 07/12/2007 F LOG CABIN FLORIST SiteID: 015-021-002172 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employtee Training 02/02/2007 ~ MSDS SHEETS SN COMPANY SAFETY MANUAL AND POSTED. BRIEF SUMMARY OF TRAINING PROGRAM: APPROXIMATELY EVERY 2-3 WEEKS WE HOLD A MEETING WITH ALL EMPLOYEES ON AREAS THAT MIGHT BE A DANGER FOR EMPLOYEES. THE FORM IS SIGNED BY EMPLOYEES AND INCLUDED IN OUR COMPANY SAFETY AND HEALTH PROGRAM MANUAL. POSTERS AND FORMS ARE KEPT CURRENT BY MANAGEMENT. rayc a aac~.u ivt L•u~.ui.c vac Held for Future Use -8- 07/12/2007