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Home My WebLink AboutBUSINESS PLAN--- ~- -{~ F_5_I_Bakersfieid. ~- 3818 Buck Owens Blvd J. a ~ i F S I BAKERSFIELD Manager RYAN WHEELER Location: 3818 BUCK OWENS BLVD City BAKERSFIELD CommCode: KCFD STA 64 EPA Numb: SiteID: 015-021-002021 BusPhone: (661) 852-0682 Map 102 CommHaz Extreme Grid: 12B FacUnits: 1 AOV: SIC Code:5084 DunnBrad:17-327-7666 Emergency Contact / Title Emergency Contact / Title RYAN WHEELER / BRANCH MANAGER WAYNE HILLIARD / PRESIDENT Business Phone: (661) 852-0682x Business Phone: (559) 275-2993x 24-Hour Phone (661) 201-0527x 24-Hour Phone (661} 932-3211x Pager Phone ( ) - x Pager Phone (661) 399-2308x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact ~f "zA,6c~l~ ~A/y Phone: (661) 831-6014x MailAddr: 3818 BUCK OWENS BLVD State: CA City BAKERSFIELD Zip 93308 Owner FORK LIFT SPECIALTIES INC Phone: (559) 275-2993x Address 3711 W FRANKLIN AVE State: CA City FRESNO Zip 93706 Period to TotalASTs: = Gal Preparers TotalUSTs: _ Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ~N~'~ ~ .,, ~ ~ ~ ~QQ7 F3ased 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. ~_1~1'GQ d o~~ ~ S' ture Dat -1- 01/31/2007 P F S I BAKERSFIELD SiteID: 015-021-002021 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE E F P IH G 1455.60 FT3 Hi ACETYLENE E F P IH G 330.00 FT3 Hi BATTERIES F IH S 105.00 LBS Hi TUBMATE - ALL PURPOSE F DH S 200.00 LBS Mod BREAKTHROUGH IH L 150.00 GAL Mod CARBON-ATE PLUS L 100.00 GAL Mod DEGREASER F IH DH L 80.00 GAL Mod TUBMATE GENERAL PURPOSE L 80.00 GAL Mod SODIUM HYDROXIDE F IH DH L 55.00 GAL Mod CARBON-ATE L 10.00 GAL Mod OXYGEN F IH DH G 281.00 FT3 Low WASTE OIL F DH L 110.00 GAL Low RIPPER I IH DH L 80.00 GAL Low WASTE ANTIFREEZE F DH L 55.00 GAL Low CARBOCHLOR R DH L 10.00 GAL Low GREASE F DH S 120.00 LBS Min MOTOR OIL F DH L 110.00 GAL Min HOTSY RED L 20.00 GAL UnR -2- 01/31/2007 -3- 01/31/2007 F F S I BAKERSFIELD SiteID: 015-021-002021 ~ ~ Inventory Item 0015 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site PARAFFINIC HYDROCARDON 365 Location within this Facility Unit Map: Grid: SE CRNR SHOP CAS# 74-98-6 STATE T TYPE T PRESSURE ~~ TEMPERATURE ~~ CONTAINER TYPE ~ ~GdS I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1455.60 FT3 1455.60 FT3 727.80 FT3 I1tiG1-iCCLV U J l.Vl•lYV1V P~1V 1 J °sWt. RS CAS# 100.00 Propane Yes 74986 I1riGtiiCL H. 7JP~.7J1.1P~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: W WALL SHOP BY DOOR CAS# 74-86-2 ~GasATE TPureE ~-AboveSAmbient AmbientT~E PORTCOPRESSERCYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 330.00 FT3 330.00 FT3 I 330.00 FT3 nr~uru~L V U .7 1. V1Rt' V1V L~1V 1 ~7 oWt. RS CAS# 100.00 Acetylene Yes 74862 rlti[~tiiCL ti a~J r+J .71.1L~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi -4- 01/31/2007 F F S I BAKERSFIELD SiteID: 015-021-002021 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME BATTERIES Days On Site 365 Location within this Facility Unit Map: Grid: PARTS COUNTER CAS# STATE TYPE ~ PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixture I Ambient ~ Ambient BOX AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10.50 LBS 105.00 LBS 105.00 LBS riHGHKLV U.7 1:V1~1rV1V~1V 1.~ gWt. RS CAS# 35.00 Battery Acid No 7664939 10.00 Nickel Oxide No 1313991 5.00 Cadmium Oxide (EPA) No 1306190 t11~GHKL 1~a5J;JJ1~1L1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH / / / Hi ~ Inventory Item 0018 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME TUBMATE - ALL PURPOSE Days On Site 365 Location within this Facility Unit Map: Grid: E WALL SHOP CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixtur~ Ambient ~ Ambient BOX AMOUNTS AT THIS LOCATION Largest Con45100rLBS Daily 200100m LBS I Daily 100r00e LBS t1t~GSittUVUJ ~VrlrVlv~lvla °sWt . RS CAS# 60.00 Sodium Metasilicate No 6834920 5.00 Ethylene Glycol Monobutyl Ether No 111762 5.00 Ethoxylated Alcohol No 110805 t1E~G11hCL 1~b7~751~1t;1V17 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod -5- 01/31/2007 F F S I BAKERSFIELD ~ Inventory Item 0008 COMMON NAME / CHEMICAL NAME BREAKTHROUGH Location within this Facility Unit E WALL SHOP SiteID: 015-021-002021 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# Liquid TMixtur~Ambient~E ~ AmbientT~E DRUM/BNARRELEMETALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 150.00 GAL 150.00 GAL 150.00 GAL tiL~GE1K11VU~ I:VL~lYV1V1'1V15 %Wt. RS CAS# 5.00 Ethoxylated Alcohol No 110805 5.00 Ethylene Glycol Monobutyl Ether No 111762 5.00 Sodium Metasilicate No 6834920 t1AGAt~C1J H~5>JaJ1~11;1V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA ~ USDOT# 'MCP No No No No/ Curies IH / / / Mod ~ Inventory Item 0010 Facility Unit: Fixed Containers at Site ~ COMMON NAME'/ CHEMICAL NAME CARBON-ATE PLUS Days On Site CAR SOAP WITH WAX 365 Location within this Facility Unit Map: Grid: E WALL SHOP CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixtur~mbient ~ Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 100.00 GAL 40.00 GAL nt~atucl~ V U ~ ~.vl~irvly lJly t ~ %Wt. RS CAS# 5.00 Ethoxylated Alcohol No 110805 5.00 Ethylene Glycol Monobutyl Ether No 111762 7.00 Sodium Metasilicate No 6834920 rLS~~tircL ~,~~~a~l~i~tvta TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Mod -6- 01/31/2007 Liquid TMixture~Ambientv+y Largest Container 55.00 GAL Ambient ~ ..~_Y AMOUNTS AT THIS LOCATION Daily Maximum 80.00 GAL CONTAINER TYPE _ DRUM/BARREL-METALLIC Daily Average 40.00 GAL nt~~.ytcLVU~ ~vi~irVlv~lvl~ %Wt. RS CAS# 10.00 Sodium Hydroxide No 1310732 5.00 Sodium Metasilicate No 6834920 tia'~GLit[L Ei ~5~a.71~l~1v 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0019 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME TUBMATE GENERAL PURPOSE Days On Site TML FLOOR SCRUBBER 365 Location within this Facility Unit Map: Grid: E WALL SHOP CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 80.00 GAL 40.00 GAL ril-~Gtj.tC.L V U w7 1. V1~lY V1V L' 1V 1 J oWt. RS CAS# 13.00 Sodium Metasilicate No 6834920 5.00 Carbolic Acid No 108952 t1EiGHiC1J L-~. 7JL" J.71~1L" 1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP . No No No No/ Curies / / / Mod -7- 01/31/2007 F F S I BAKERSFIELD SiteID: 015-021-002021 ~ ~ Inventory Item 0017 Facility Unit: Fixed Containers at Site ~ F F S I BAKERSFIELD SitelD: 015-021-002021 ~ ~ Inventory Item 0007 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME SODIUM HYDROXIDE Days On Site 365 Location within this Facility Unit Map: Grid: E WALL SHOP CAS# 1310-73-2 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~ Ambient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ~ Daily Average 55.00 GAL 55.00 GAL 55.00 GAL tic-~~~tcliv~~ ~:vrir~lV~iVla %Wt. RS CAS# 100.00 Sodium Hydroxide No 1310732 r~Gr-ucL ti5~~~ai~i~lyl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0009 COMMON NAME / CHEMICAL NAME CARBON-ATE Location within this Facility Unit E WALL SHOP STATE TYPE PRESSURE Liquid TMixture ~ Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE _ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 10.00 GAL 40.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 5.00 Ethoxylated Alcohol No 110805 5.00 Ethylene Glycol No 107211 7.00 Sodium Metasilicate No 6834920 Y1HGL~tCL L-1J ,7r,.7J1~1~C,1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Mod -8- 01/31/2007 F F S I BAKERSFIELD ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit W WALL SHOP BY DOOR STATE TYPE T PRESSURE _ Gas TPure I Above Ambient SiteID: 015-021-002021 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 281.00 FT3 281.00 FT3 281.00 FT3 • tiAGi-1tCLVUJ l.:Vi~lYV1VL'1V15 %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 ti1~GE~iC1J H~JI;JJ1~11;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0005 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: S WALL SHOP CAS# 221 Liquid TWaste ~mbRent~E ~ AmbientT~E DRUM/BARRELEMETALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 110.00 GAL 110.00 GAL riL~iGEiL[LVUD 1.V1~lYV1Vr,1V1.7 oWt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 tlL-~GY.1CL H.7aL" .7.71~1L" 1V l w7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -9- 01/31/2007 F F S I BAKERSFIELD ~ Inventory Item 0016 COMMON NAME / CHEMICAL NAME RIPPER I Location within this Facility Unit E WALL SHOP SiteID: 015-021-002021 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 80.00 GAL 40.00 GAL - riHGHKLV U ~ l.:vl~lrvly tSly 1 oWt. RS CAS# 5.00 Ethoxylated Alcohol No 110805 riAGH.ttL H~Jt5551~1t51V l J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Low .Inventory Item 0006 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE ANTIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: S WALL SHOP CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste -~mbient ~ Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 55..00 GAL HAZARDOUS COMPONENTS oWt. RS CAS# 30.00 Ethylene Glycol No 107211 ri1~GKttL H~J~~51~1L'1V l~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -10- 01/31/2007 F F S I BAKERSFIELD ~ Inventory Item 0011 COMMON NAME / CHEMICAL NAME CARBOCHLOR Location within this Facility Unit E WALL SHOP SiteID: 015-021-002021 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Liquid TMixture~Ambient ~ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ~ Daily Average 55.00 GAL 10.00 GAL 55.00 GAL t1HGHKLVU~ lrV1~lYV1Vr;1V15 sWt. RS CAS# 5.00 Sodium Metasilicate No 6834920 5.00 Ethylene Glycol No 107211 5.00 Ethoxylated Alcohol No 110805 t1E~GHttL AJJ1"~~~1°1tS1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R DH / / / Low ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME GREASE Days On Site 365 Location within this Facility Unit Map: Grid: S WALL SHOP CAS# 64742-52-5 STATE T TYPE ~~ PRESSURE TEMPERATURE ~ CONTAINER TYPE Solid I Mixture I Ambient ~ Ambient I DRUM/BARREL-METALLIC I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ( Daily Average 120.00 LBS 120.00 LBS 120.00 LBS t11~GH.tCLVU.7 1.V1~lYV1V1=,1V 1.7 oWt. RS CAS# 100.00 Heavy Machine Oil No 8020835 riHGL-~tCL L-1~ J1=,~J1~1~1V 1J TSecret RS BioHaz Radioactive/Amount -EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -11- 01/31/2007 'i. F F S I BAKERSFIELD SiteID: 015-021-002021 ~ ~ Inventory Item 0014 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME " MOTOR OIL Days On Site PENNZOIL LONG-LIFE ENGINE OIL 365 Location within this Facility Unit Map: Grid: S WALL SHOP CAS# 8020835 Liquid TMixture ~mbRient~E ~ AmbientT~E DRUM/BARRELEMETALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 110.00 GAL 110.00 GAL ti1~L,AttUVUa l;vl~lrvlvt5ly 15 °sWt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 riAY,HttL 1-~7at5JJ1~1~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min ~ Inventory Item 0012 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HOTSY RED Days On Site 365 Location within this Facility Unit Map: Grid: E WALL SHOP CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture~Ambient ~ Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 20.00 GAL 10.00 GAL HAZARDOUS COMPONENTS , oWt. RSI CAS# riHGEiKL 1-~,J .7t:,5J1"1~1V l TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UnR -12- 01/31/2007 F F S I BAKERSFIELD SiteID: 015-021-002021 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/21/2006 ~ 911 FIRE, MEDICAL, POLICE; 326-3979 BAKERSFIELD FIRE DEPT ENV SERV; 800-852-7550 CALIFORNIA OES; AND 862-8700 KC ENV HEALTH. Employee Notif./Evacuation 04/14/2000 EXIT BLDG AFTER EXTENT OF SPILL DETERMINED AND NOTIFICATION TO PROPER AUTHORITY. Public Notif./Evacuation Lu~ciycii~..Y a-acui~.a.i riaii -13- 01/31/2007 F F S I BAKERSFIELD SiteID: 015-021-002021 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/14/2000 ~ KEEP ALL CONTAINERS CLOSED AND SEALED. Release Containment 04/14/2000 CONTAIN SPILL WITH ABSORBENT MATERIAL. Clean Up 04/21/2006 CALL COLES SERVICES 322-8258. v~..llci LCCaVU1~:c til.:l..1VC11.1V11 -14- 01/31/2007 F F S I BAKERSFIELD SiteID: 015-021-002021 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JC l: 1ci1 naGaLUa Utility Shut-Offs 01/31/2007 A) GAS - N/A B) ELECTRICAL - OUTSIDE W WALL N END OF BLDG C) WATER - CTR N WALL OUTSIDE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 11/15/2006 PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS IN SHOP AND AUTOMATIC SPRINKLER SYSTEM. NEAREST FIRE HYDRANT - FRONT OF BLDG. Building Occupancy Level ~''~EMPLOYEES ~~ 03/27/2006 -15- 01/31/2007 F F S I BAKERSFIELD SiteID: 015-021-002021 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 04/21/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MONTHLY REVIEW OF MSDS REQUIREMENTS ON ALL NEW CHEMICALS. TRAINED IN PROPER STORAGE AND HANDLING OF CHEMICALS. MONTHLY SAFETY MEETINGS. rc~yc ~ nciu Lvi ru~.uic ~~c Held for Future Use -16- 01/31/2007 \. >Jwii~J ill ..j~ rn'7 ~dN _... _ ., ~t PG v~n~ ~ d`"~~I~ ~ ~ ~'7I~P yoo`q ~ co ~ -fin ooQ . ~ ~ . .~.,„ .1..• .. ~ . .w ~ t ~~ • , ~ ~. ~ ~ A ~ i O_ wAt ~. o~ aZ E~~~~1 -1~ ~ ~ Q w .~s f + _ h p.,I~ rN~~a.e ~ 1 b ~~icr .. ~~'.~ N ~ 3 a a N~ o L rc K !'r ~ v t~ ~ s ~ M~ ~ ~~ i M' O~Sr1C ~ ~ ~ ® ~ ~ j.~lYir ~i R y ~Q~ ~ ~~ ~ C ~ ~ ~ ~ • V o v O . ~. y ~ ~ h , 00 ~ O O ~ _ -------- - ----- -- : _ ~. ~ , ~ dry e d ~ cti ~ ~ ~~ ~ ~ ~,, ,~~~ e A ~u ~ ~~ x•e-.~ •~ _ v , ~ ~ b V7 ~ ~ I ~ ~ h ~ ~-} b ~ V 1 ~ t% r ,~ .f' . i ? + F S I BAKERSFIELD ___________________________________ SiteID: 015-021-002021 + Manager RYAN WHEELER Location: 3818 BUCK OWENS BLVD City BAKERSFIELD BusPhone: (661) 852-0682 Map 102 CommHaz High Grid: 12B FacUnits: 1 AOV: CommCode: KCFD STA 64 EPA Numb: SIC Code:5084 DunnBrad:17-327-7666 Emergency Contact / Title Emergency Contact / Title RYAN WHEELER / BRANCH MANAGER WAYNE HILLIARD / PRESIDENT Business Phone: (661) 85.2-0682x Business Phone: (559) 275-2993x 24-Hour Phone (661) 201-0527x 24-Hour Phone (6`t) `13Z -3~.t1 x Pager Phone ( ) - x Pager Phone (661) 399-2308x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact Phone: (661) 831-6014x MailAddr: 3818 BUCK OWENS BLVD State: CA City BAKERSFIELD Zip 93308 Owner FORK LIFT SPECIALTIES INC Phone: (559) 275-2993x Address 3711 W FRANKLIN AVE State: CA City FRESNO Zip 93706 Period to TotalASTs: = Gal Preparers TotalUSTs: ~ = Gal Certif' d: RSs : No ParcelNo: Emergency Directives: ~ PROG A - HAZMAT PROG H - HAZ WASTE GEN EN~p~~R~~2o os tsised oi~ 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 t~elieve the information is true, accurst ,and complete. store Da -1- 03/28/2006 UNIFIED PROGRAM INSPECTION CHECKLIST ~ r~R~ SECTION 1: Business Plan and Inventory Program y BAKERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAMFi~ ON DATE SP ECTI N INSP ECTION TIME 7 / / M ? ADDRESS HONE NO. O OF EMPLOYEES 3 /v ~s FACILITY CONTACT USINESS ID NUMBER / 15-021- ~ N Section 1: Business Plan and Inventory Program OUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c.Compliance` OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~.. ~ BUSIf1ASS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ 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 ROCEDURES ; ~y7 ^ EMERGENCY PROCEDURES ADEQUATE ; ~ r t~ 7 ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ` ~ ~ .. ~r i 7 ~ ( `.t, SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? J~YES ^ NO EXPLAIN: ~-"~ay '^ yli.OC`ls' ~9i ~ _ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (861) 326-3978 1~~~~--~~~ ~ r Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Station # Busin ite/School Site Responsible rty (Please Prat) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2048 (Rev. 02105)