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llNIFIE® PROGRAnII INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Environmental Services
900 Truxtun Ave., Suite 2i0
Bakersfield, CA 93301
Tel: (661) 326-3979
FACILITY NAME ~ n INSPECTIO^DATE INSPECTION TIME
1
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ADDRESS ~~ _'` --- - ------- -- - ---- - P~E No. ~ No. of ~ ployees
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FACILITYCONTACT Business ID Number ~~ ~ p~ (~
~1 ~ 15-021- U \Ud/
Section 1: Business Plan and Inventory Program
Routine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection
•
ANY HAZARDOUS WASTE ON SITE?: OYES ~I NO
EXPLAIN:
•
QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (661) 326-3979
_ ~~~ ~
Inspector (Please Print) iF re Prevention 1st-In/Shik of Site B siness Si Responsible Party (Please Print)
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White -Environmental Services Yellow -Station Copy Pink • Business Copy
UNIFIED PROGRAM INSPECTION CHECKLIST
Bakers$eld Fire Dept.
~' Environmental Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel: (661) _326-3979 _ _ ___ _ _ _
SECTION 1 Business ,Plan and Inventory Program
•
FACILITY NAME ~ r INSPECTION DATE INSPECTION TIME
ADDRESS PHONE tJo. No. of Employees
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FACILITYCONTACT ~ Business 10 Number
15-021- 6
Section 1: Business Plan and Inventory Pmgiram
~2outine O Combined ^ Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection
C V OPERATION
ti
n`~ COMMENTS
on
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^ APPROPRIATE PERMIT ON HAND
^
BUSINESS PLAN CONTACT INFORMATION ACCURATE
l~ ^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY
^ ~ VERIFICATION OF INVENTORY MATERIALS
----
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^ ----------_------ ------. _V ....--- ------- ..__ . _-.....-. I
VERIFICATION OF QUANTITIES __. _ ... ........... .. . ...__ _ ... _............ ... _._... _ . _____. ...----.. _......
L~J ^ .VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
^ VERIFICATION OF MSDS AVAILABILITYE
-- - --
^ - ------- - --- ....--- --- - .._......... _ ----- __._ ._ ..._- -
VERIFICATION OF HAT MAT TRAINING i -.. -_.. _ _._.._. _ . ... _.. .... ... ._-.... .. --- - .--
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~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
11 ^ ~
EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
Ld ^. FIRE PROTECTION ~
^ S
ITE DIAGRAM ADEQUATE S ON HAND
ANY HAZARDOUS WASTE ON SITE?: ^ YES ^ NO
EXPLAIN:
• QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~GS'I ~ 326-3979
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In or Please Print Fire Prevention 1st-INShik of Site
WhRe -Environmental Services Yelknv -Station Copy
s -- de - sponsible Party (Please Print)
Pink -Business Copy
Uf~IFIED PROGRAM INSPECTION CHECKLIST ~ '
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.SECTION 1: BusinessxPlan and Mvoentory Program ~
BAHERSFIEILD FIRE DEPT
Prevention Services
900 Truxtun Ave., Suite 210
Bakersfteld, CA 93301
Tel.: (661) 326-3979
Fax: (661) 872-2171
FACILITY NAME ~~q~- ~ NSPECTION DATE NSPECTION TIME
ADDRESS
~~~i ~- 33RD s HONE NO. O OF EMPLOYEES
FACILITY CONTACT USINESS ID NUMBER ~~
15-021-
Section 1: Business Plan end Inventory Program
^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
~~
C V ~ C=Compliance OPERATION
V=Violation COMMENTS
^ ^ APPROPRIATE PERMIT ON HAND
^ ^ BUSlflt?SS PLAN CONTACT INFORMATION ACCURATE ~~
^ ^ VISIBLE ADDRESS ~ _~J
~/~ `
^ ^ CORRECT OCCUPANCY
^ ^ VERIFICATION OF INVENTORY MATERIALS
^ ^ VERIFICATION OF QUANTITIES
^ ^ VERIFICATION OF LOCATION
^
^ ^
^ PROPER SEGREGATION OF MATERIAL
VERIFICATION OF MSDS AVAILABILITY
~ITTrD s7 ~ f
^ ^ VERIFICATION OF HAZ MAT TRAINING
^ ^ VERIFICATION OF ABATEMENT SUPPLIES ANO
PROCEDURES
^ ^ EMERGENCY PROCEDURES ADEQUATE
^ ^ CONTAINERS PROPERLY LABELED
^ ^ HOUSEKEEPING
^. ^ FIRE PROTECTION
^ ^ SITE DIAGRAM ADEQUATE 8 ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
O YES ^ NO
QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (861) 32E-3979
Inspector (Please Print) Fire Prevention / i" In / Shik of Site/Station aY
Business Site/School SNe Responsible Party (Please Print)
White - Prwention Sarvieas Yallow -Station Copy Pink - Buainesa Copy FD2049 (Rw. 02105)
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FIRE PREVENTION INSPECTION
BAKERSFIELD FIRE DEPT.
B E R S P I D Prevention Services
Flli<E 900 Truxtun Ave., Ste. 210
ARTM ~ Bakersfield, CA 93301
Tel.: (661) 326-3979 ^ Fax: (661) 852-2171
DISTRICT BLOCK NO. DATE EE ~ ~8
FACILITY ADDRESS /
/ CITY, STA P
FACILITY NAME
~ r MANAGER'S NAME FACILITY PHONE NO.
BUSINESS OWNER'S AME AND ADDRESS CITY, STATE, 21P OWNER'S PHONE NO.
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO.
OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISER DATE
^ YES ^ NO
CORRECT ALL VIOLATIONS wo~~rioN
CHECKED BELOW Ho. REQUIREMENTS
MBUSTI
WASTE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.)
CO
BLE
VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its
safe disposal. (U.F.C.)
COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse box/fire door (N.E.C.) (U.F.C.)
4 Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the top to the
extinguisher not more than 5 feet above the floor. (N.F.P.A. No. 10)
ExTINGUISHERS 5 Provide and install (amount) _____ approved (type & size) __________________ portable fire extinguisher to be
immediately accessible for use in (area) _____________________________ (U.F.C.)
g Re-charge all fire extinguishers. Fire extinguishers shall be serviced at least once each year, and/or after each use,
by a person having a valid license or certificate. (U.F.C.)
SIGNS 7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (door/window) to
fire escape. (U.F.C.)
g Provide and maintain appropriate numbers on a contrasting background and visible from the street to indicate the
correct address of the building. (B.M.C.) (U. F.C.)
FIRE DOORS/
FIRE SEPARATIONS g Repair all (cracks/holes/openings) in plaster in (location) ______________________________________. Plastering
shall return the surface to its original fire resistive condition. (U.B.C.)
10 Remove/repair (item & location) _________________________________________________________. Self-closing
doors shall be designed to close by gravity, or by the action of a mechanical device, or by an approved smoke and
heat sensitive device. Self-closing doors shall have no attachments capable of preventing the operation of the
closing device. (U.F.C.)
ExITS 11 Remove all obstruction from hallways. Maintain all means of egress free of any storage. (U.F.C.)
12 Provide a contrasting colored and permanently installed electric light over or near required exit (location)
______________________________ to clearly indicate it as an exit. (U.F.C.)
STORAGE 13 Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire
escapes/stair shafts are to be maintained free from obstructions at all times.) (U.F.C.)
ELECTRICAL APPLIANCES 14 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved electrical outlets
where needed. (N.E.C.) (U.F.C.)
15 Remove multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (N. E.C.) (U.F.C.)
OUTDOOR BURNING 16 Violation of Section 1102 dealin with recreational fires or o en burnin U.F.C.
FIREWORKS 17 Violations of Section 7802 U.F.C. or 8.49,040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks.
OTHER 18
CUSTOMER:
(Signature) (Please Print Name Legibly, Title)
INSPECTOR: AP NO.:
(Signature) LEGEND:
C.F.C. CALIFORNIA FIRE CODE
U.B.C. UNIFORM BUILDING CODE
B.M.C. BAKERSFIELD MUNICIPAL CODE
N.F.P.A. NATIONAL FIRE PROTECTION
ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
White -Customer/Original Yellow -Station Copy Plnk -Prevention Services FD 2022 (Rev. 09!05)
V, ~~ y, ~_
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+ GILS WELDING ________________________________________ SiteID: 015-021-001068 +
Manager BusPhone: (661). 329-7395
Location: 1331 33RD ST Map 103 CommHaz High.
City BAKERSFIELD Grid: 19C FacUnits: 1 AOV:
CommCode: BFD STA 04
EPA Numb:
SIC Code:l799
DunnBrad:56-466-5140
Emergency Contact / Title Emergency Contact / .Title
GIL ROBBINS / 1
Business Phone: (661) 329-7395x Business Phone: ( ) - x
24-Hour Phone ( ) - x 24-Hour Phone ( ) - x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact Phone: (661) 329-7395x
MailAddr: 2400 WESTHAVEN AVE State: CA
City BAKERSFIELD Zip 93304-5454
Owner GILBERT L ROBBINS Phone: (661) 329-7395x
Address 2400 WESTHAVEN AVE State: CA
City BAKERSFIELD .Zip 93304-5454
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives: ~
PROG A - HAZMAT
~a~a~ on my inquiry of those individuals
rer~panslble tar attaining the Information, I c®rtify
under penalty of law that I have personally
examinQd and am familiar with the Information
submitted and believe the information is true,
accurate, and complete.
Signature Date
-1- 08/29/2006