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~~y~ ~"~~ CITY OF BAKERSFIELD FIRE DEPARTMENT
~~ OFFICE OF ENVIRONNiIr:NTAL SERVICES
~ •y~ UNIFIED PROGRAM INSPECTION CHECKLIST
`~,,;r~~' ~~,~~ 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301
FACILITY NAME 1--~~~ ~= L ~ ~- i >'~ t~ ~-- INSPECTION DATE j (I l 5 I a 3 _
ADDRESS I `~ / L ~ :. I ~'i TM s ~ PHONE NO. ~a 7 - a ~- ~ 3
FACILITY CONTACT I ' s~_ BUSINESS (D NO. 15-2iU- CI~OJ/~S'7
INSPECTION TIME` NUMBER OF EMPLOYEES u
Section l:
~outine
Business Plan and Inventory Program
^ Combined ~ Joint Agency ^ Multi-Agency [) Complaint ^ Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand
Business plan contact information accurate
Visible address
Correct occupancy
Verification of inventory materials ~ ~~
~~~ ~
Verification of quantities ~T~ Ned o5
Verification of location
~ ly ir; o ~ ~j
Proper segregation of material
Verification of MSDS availability ~ /~ n7 p O 9 ~ /~ /~ o.i8
Verification of Haz Mat training ~~ L ~~ ~ J 3~ 7-~
Verification of abatement supplies and procedures ~
Emergency procedures adequate
Containers properly labeled W~5 i ' M~ `J''`v' I ~'~~ M ~ ~ i
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?: ~es ^ No
Explain: vJA ~ 1 t; rnn - ~~, ~i._ G ~ i
Questions regarding this inspection? Please call us at (661) 326-3979
White -Env. Svcs. Yellow -Station Copy Pink -Business Copy
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B siness Sit esp'', nsible Party
Inspector: ~
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+ SAN JOAQUIN ROOFING C0 ______________________________ SiteID: 015-021-001251 +
Manager BusPhone: (661) 324-2044
Location: 1501 E 19TH ST Map 103 CommHaz High
City BAKERSFIELD Grid: 28C FacUnits: 1 AOV:
CommCode: BFD STA 02 ~ SIC Code:
EPA Numb: DunnBrad:
Emergency Contact / ,Title Emergency Contact / Title
RAY GRAHAM / OWNER CARRIE YANNEY / MANAGER
Business Phone: (661) 324-2044x Business Phone: (661) -3~-4-~~"~~-samlz
24-Hour Phone (661) 393-6589x 24-Hour Phone (661) -2-~3-`--~~.8~1-05
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact Phone: (661) 324-2044x
MailAddr: 1501 E 19TH ST State: CA
City BAKERSFIED Zip 93305
Owner RAY GRAHAM Phone: (661) 324-2044x
Address 2928 MORSE CT State: CA
City BAKERSFIELD Zip 93308
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
~ Emergency Directives: ~ ~
PROG A - HAZMAT ~~~
PROG H - HAZ WASTE GEN o~
Based on my inquiry of those individuals
responsible far obtaining the information, I certify
under penalty of law that I have personalty
examined and am familiar with the information
submitted and believe the information is true,
accurate, and complete.
ignatur D to
1
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~`~\
ENT ~v~ 14 2O0
6
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-1- 06/07/2006
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Bakersfield Fire Dept.
J
`'191VI~lED PROGRAM INSPECTION CHECKLIST Enironmental Services
. ,
1715 Chester Ave
SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301
Tel: (66])326-3979
FACT ITY NAME
_ ~-
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--~~ -------- C,o_ ---- INSP~TION D TE INSPECTION TIME
S 6 S' ~ a .~, /~J
~! ~ - ------- -----------------
ADDRESS ~ PHO E No. No. of Employees
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FACILITYCONTACT
,ct} ~-~, ,4 M --- ------------ ---- - ---- - - ---- - ----- - - - ----- -- ---- - --
Business ID Number
15-021- fa0 /,Z ,S /
Secfion 1: Business Plan and Inventory Program
outine ^ Combined ^ Joint Agency ^Mu]ti-Agency ^ Complaint ^ Re-inspection
~^ VISIBLE ADDRESS
C V lV=Vioatlonncel OPERATION COMMENTS
^ APPROPRIATE JPERMIT ON HAND
^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
~^ CORRECT OCCUPANGY
l~"^ ~ VERIFICATION OF INVENTORY MATERIALS
~~^ VERIFICATION OF QUANTITIES
L7
^ VERIFICATION OF LOCATION
,/
L'7 ^ PROPER SEGREGATION OF MATERIAL
lY ^ VERIFICATION OF MSDS AVAILABILITYE
^ ^ VERIFICATION OF HAT MAT TRAINING ~ `~`
U ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
~^ EMERGENCY PROCEDURES ADEQUATE
-, -f--
YJ ^ - -------- ----- -- --_ ------ ----- -- - -- ----
CONTAINERS PROPERLY LABELED ---- - - ------ - - -- - - -- - -- ------ - -_--...-..-- _ - ----- _ - _ __...--- ---
- .. -- --
^ HOUSEKEEPING -
-----
e ~~ ~~ ~ h ~
^ FIRE PROTECTION
- ~ r----
~iC. t t~c~1 31.v~22
~d'JMi
'~t1Z~L-
~ ----- ---- - - -- -. __._
___
---
------
^ SITE DIAGRAM ADEQUATE & ON HAND
i•
ANY HAZARDOUS WASTE ON SITE: ~ ^ NO
EXPLAIN: W ~T~'~~Z rY~d ~ Vim- Q ~^~
• QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~66~ ~ 328-3979
~~~2; ~vTL~z.QG ~----- ---- ----~ ^- L ---------
Inspector (Please Print) Fire Prevention 1st-In/Shift of Site
White -Environmental Services Yellow -Station Copy
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Business a Responsible Party (Please Print)
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Pink -Business Copy