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U'N11=1ED PROGRAM°INSPECTION CHECKLIST A t; R-s r , n 900Truxtun Ave., Suite 210
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~.~: ~_~~ _~ . ~ ;~~ _. - M~~A ~ ., ~ ~ -.-_~ ~ ..:~ ,- - ~,~ ~... FiaE Bakersfield, CA 93301
SECTION. 1: Business Plan-and Inventory Program . ° aRrM Tel.: (661) 326-3979
- Fax: (661) 872-2171
FACILITY NAME ] _ - / DATE
INSPE TION INSPECTION TIME
n
ADDRESS - ~ - - l ~
T PHONE NO. NO OF E
M/PLOYEES
'L o 0 0 20
J_ S-~' ~p
2S ..s/ / /
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FACILITY CONTACT BUSINESS ID NUMBER
- 15-021-
Section 1: Business Plan and Inventory Program
^ ROUTINE -~i COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ( C=Compliance OPERATION."
V=Violation COMMENTS
^ ~ APPROPRIATE PERMIT ON HAND Ne ~~ ~~ 'tl--..i ~~-~~
^ '~} BUSInOSS PLAN CONTACT INFORMATION ACCURATE ~ ,q, )\ ne SS ~ ~ ~ ti
^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
~
pp
./C1" ^ VERIFICATION OF MSDS AVAILABILITY
~] ^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
^ EMERGENCY PROCEDURES ADEQUATE
C~Q ^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ ~ FIRE PROTECTION
S E'i P v l cc ~ ~ ~ ~ .., va ~ ~..
^ SITE DIAGRAM ADEQUATE & ON HAND
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ANY HAZARDOUS WASTE ON S TE? ~ES ^ NO
EXPLAIN: ~ c`~e ~~~ ~" ~
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (667) 326-
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Inspector (Please Print) Fire Prevention / 1s' In /Shift of Site/Station #
- :White -Prevention Services Yellow -Station Copy ~ - Pink -Business Copy
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FD 2155 - (Rev. 09/05
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~0~5`~ ~`~~`" CITY OF BAKERSFIELD FIRE DEPARTMENT
d b~ OFFICE OF ENVIRONMENTAL SERVICES
~' , ~~ UNIFIED PROGRAM INSPECTION CHECKLIST
4~ ~~gti 1715 Chester Ave., 3`d Floor, Bakersfield, CA 93301
FACILITY NAME l~l A lc fa ~ A r" fe INSPECTION DATE ~./ ~'~°)
Section 4: Hazardous Waste Generator Program
^ Routine ~ Combined ^ Joint Agency
EPA ID # ~.~~ ~--.v ~--
^ Multi-Agency ^ Complaint O Re-inspection
OPERATION C V COMMENTS
Hazardous waste determination has been made
EPA ID Number ~ ~ w ~--
Authorized for waste treatment and/or storage .
Reported release, fire, or explosion within 15 days of occurrence
Established or maintains a contingency plan and training
Hazardous waste accumulation time frames
Containers in good condition and not leaking
Containers are compatible with the hazardous waste
Containers are kept closed when not in use
Weekly inspection of storage area
Ignitable/reactive waste located at least 50 feet from property line /~~'
Secondary containment provided
Conducts daily inspection of tanks
Used oil. not contaminated with other hazardous waste ~ ._N
Proper management of lead acid batteries including labels ~J~ °
Proper management of used oil filters ~)ib
Transports hazardous waste with completed manifest '
Sends manifest copies to DTSC h ~ S d ~ ~,, t , ~
Retains manifests for 3 years
Retains hazardous waste analysis for 3 years
Retains copies of used oil receipts for 3 years ~
Determines if waste is restricted from land disposal
~=~,ompnance v=vtotanon
Inspector: ~'~~-~~
Office of Environmental Services (661) 326-3979
White -Env. Svcs.
e s esponsible Party
Pink -Business Copy
SELF-CERTIFICATION CHECKLIST
Fire Prevention
BAKERSFIELD FIRE DEPT.
Prevention Services
1600 Truxtun Ave Ste 401
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME:
~Q ~. ~I/aka .na D,r~s 1~r~, ELF-CERTIFICATION DATE:
~, /8, O
SITE ADDRESS ZIP CODE
Zavo- 20 ?-s+~ sT; BQkC~s,~;e/~ Ca. 93 30/ HONE NUMBER
~~o/~ ~25~ S"/97
MAILING ADDRESS ZIP CODE AX NUMBER:
Zooo - ,2o Ts/ S4'-. ~Q,~efs'~'eld ~/. ~1330~ GG/. 325 3'"77
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DO NOT DISCARD -FAILURE TO RETURN WILL RESULT IN FIRE DEPARTME.NT_INS.PECTION `:..
INSTRUCTIONS: Please verify and check each item as appropriate. Include comments on each line or at the bottom as necessary.
en completed, make a second copy for your records and mail the original to the address above. Failure to return will result in inspection.
Y N .OPERATION COMMENTS
~ ^ Spent fluorescent tubes saved in a suitable container and recycling*
(' If you rely on an outside agency for the recycling, please indicate the name, address, and phone number of the
agency that removes your tubes.) Name:
hone No.:
ddress:
^ Waste batteries saved in suitable container for recycling*
^ Discarded electronic devices saved for recycling*
^ Discarded items containing Mercury saved for recycling*
~, ^ Discarded non-empty aerosol spray cans saved for recycling*
^ Current annually serviced "ABC Type" fire extinguisher every 75 feet of travel
D Extension cords not used in place of what should be permanent wiring
^ All exits indicated by exit signs, not more than 100 feet apart, if occupant load
is 100 or more
K1J ^ Minimum of 30 inches of clearance in front of electrical panels
^ Cover plates installed on all electrical outlets, switches, and junction boxes (no
exposed wiring)
^ Flammable and combustible material stored properly and not adjacent to a
source of ignition (check hot water heater and furnace area)
^; ~j Do you use or store any hazardous materials on site?
^ i~ Does your building have a monitored fire alarm system?
^ ~ Does your building have a fire suppression (sprinkler) system?
Recycle at the Kern County Special Waste Facility, 4951 Standard Street, Bakersfield, CA 93308. Phone: (661) 862-8922
COMMENTS:
QUESTIONS REGARDING THIS CHECKLIST? PLEASE CALL US AT (661) 326-3979
Signature Business Site /Responsible Party (Please Print)
\~ nO~~FD 2155b (Rev. 09/06)