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__ _ _ __ ~ • " BKFLD GROCERY WHOLESALE ~ -, 402-CALIFORNIA-AVENUE= _- - ~~ -- -- -- UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1:. Business Pian and Inventory Program , i• ~> I ~;.~;~~-' Prevention Services A A e R s r, 900'Ihixtun Ave., Suite 210 FARE Bakersfield, CA 93301 -. ARTM Tel.:- (661) 326-3979- - Fax: (661) 872-2171 FACILITY NAME - INSPECTION DATE - INSPECTION TIME ADDRESS PHONE NO. NO OF EMPLOYEES FACILITY CONnnTACT - J/i'`~'r/ l ~ ~~ BUSINESS ID NUMBER - 15-021- ~i~s2~ .Section 1: Business Plan: and Inventory Program ~_-l ,_,, ~ LAY ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT. ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ,~/ L'am' ~ APPROPRIATE PERMIT ON HAND ~f BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ ,/ I~ ^ VISIBLE ADDRESS M V ~ ~~^ CORRECT OCCUPANCY la~^ VERIFICATION OF INVENTORY MATERIALS I~^ VERIFICATION OF QUANTITIES , L7 ^ VERIFICATION OF LOCATION ~Q'/ g t~~^ PROPER SEGREGATION OF MATERIAL ^ L~ VERIFICATION OF MSDS AVAILABILITY ~~ ~~~ Yr VERIFICATION OF HAZ MAT TRAINING ^ ~ ~ ~~ o0 _ ^ LT VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ ~~ ^ ©~ EMERGENCY PROCEDURES ADEQUATE ~~,,~~ ~~ ~~. / ~/ ©~^ CONTAINERS PROPERLY LABELED HOUSEKEEPING ^ , ^ L~ t-IRE PROTECTION ~~~~~~ ' ~~ ^ SITE DIAGRAM ADEQUATE & ON HAND ~~~~ ~ ~~~~ ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIO SS REGARDING IS PECTION? PLEASE CALL US AT (661) 326-3979 /7 ~~~ Inspector (Please Print) Fire Prevention / 1s~ In /Shift of Site/Station # i White -Prevention Services - - Yellow -Station Copy- Pink -Business Copy FD 2155 (Rev. 09/05 '~ _ - - - ^ YES L7'NU 5gi43 BAKERSFIELD GROCERY WHOLESALE SiteID: 015-021-0028'75 Manager ,_~~~~~~ ~~ZA~ BusPhone: (661) 861-8900 Location: 402 CALIFORNIA AVE Map 103 CommHaz High City BAKERSFIELD Grid: 31B FacUnits: 1 AOV: CommCode: BFD STA 06 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title DAVID AEZAH / OWNER / Business Phone: (661) 861-8900x Business Phone: (~ )~~~ -~l~Vx 2 4 -Hour Phone ( ) - x 2 4 -Hour Phone (~() 3 ~/T - /~/~ Jx Pager Phone ( ) - x Pager Phone _( ` - x Hazmat Hazards: Fire ImmHlth DelHltti ....._....... Contact ~ 1~!/'/~~ 1~~2i9~ Phone: (661) 861-8900x MailAddr: 4 2 CALIFORNIA AVE State: CA City. BAKERSFIELD Zip 93304 ....... Owner DAVID AEZAH Phone: (661) 343-1487x Address 402 CALIFORNIA AVE State: CA City BAKERSFIELD Zip 93304 •Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~~ t~aa'ed 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 information is true, th ~~~ ~~~ A'9 e submitted and believe ~o UU/ accurate, and comple .,. ~-C•-v? ' nature Date -1- O1/25/~007 i F BAKERSFIELD GROCERY WHOLESALE ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-002875 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ............. BLEACH IH ~ L 200.00 GAL ~t AUTO TRANSMISSION FLUID F DH L 75.00 GAL ' Lbw MOTOR OIL F DH L 200.00 GAL Min -2- O1/25/~007 -3- 01/25/2007 F BAKERSFIELD GROCERY WHOLESALE SiteID: 015-021-002875 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE CENTER N END OF BLDG CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily.Average 1.00 GAL 200.00 GAL 200.00 GAL t11~Y,KKL V U .5 1. V 1~1Y V1V J;1V 1 b %Wt. RS CAS# 100.00 Bleach No 7681529 riHGHKL xa~n~alnc~ly 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Hi ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME AUTO TRANSMISSION FLUID Location within this Facility Unit INSIDE NW CRNR OF BLDG STATE TYPE PRESSURE Liquid TMixture ~mbient Days On Site 365 Map: Grid: --- CAS# 64742-65=0 TEMPERATURE ~~ CONTAINER TYPE Ambient I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 75.00 GAL 75.00 GAL riHY,EiKLVUJ 1:V1~lYV1V~1V 1 7 %Wt. RS CAS# 100.00 Transmission Fluid (Petroleum-Based) ~ No 0 ~YlAGt1K.L tia a~a5ri~ly 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCp No No No No/ Curies F DH / / / Low Facility Unit: Fixed Containers at Site ~ -4- 01/25/2007 t F BAKERSFIELD GROCERY WHOLESALE SiteID: 015-021-002875 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: ---- INSIDE NW CRNR OF BLDG CAS# 8020535 Liquid TYPE PRESSURE TEMPERATURE TSTICTCONTAINERE TMixture r Ambient ~ Ambient AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 200.00 GAL 200.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 ntjt,r~uct~ r~a ~~a~i~i~lvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCp No No No No/ Curies F DH / / / Min -5- 01/25/2007 +• 1 F BAKERSFIELD GROCERY WHOLESALE SiteID: 015-021-0028'75 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification e- ~ ,,~-e, v ~ G~~- ~' ~Lll~J1U~/CC 1VU1.11. / ~VdULLdl,lUil rl1lJ11c 1VU1.11. / ~VdCUdL1UII Emergency Medical Plan ~- ~~/ -6- 01/25/2007 ~ BAKERSFIELD GROCERY WHOLESALE SiteID: 015-021-00285 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Sits ~ ~ Release Prevention Release Containment l.1Cd11 UiJ ~~/ ~-~ /.~ lob-' ~/~,t.~L i~' ,~ ~iz~~~ ~ ~ . V1.11C1 ICCSVUt I:C til:Ll Vdl.l Vll -7- 01/25/2007 4, ~l F BAKERSFIELD GROCERY WHOLESALE SiteID: 015-021-0028'75 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .~Nc~..iai nac.aius ~~.lii~y ~iiu~-vies ~ Slu~~~ ~~~~a-~ Wvi~h ,_ r-ire rroLec.~rwail. water --_ ~" ~/ -8- O1/25/~007 :> :~ F BAKERSFIELD GROCERY WHOLESALE SiteID: 015-021-0028'75 ~ Fast Format ~ ~ Training Overall Site ~ t'+lll~Jl Vy CC iLCL 1111111. ~~ ~~ ' rayc a 17CLlA LVL t uLULC U.7-C nclu LVL r ul.uLC U~7'C -9- 01/25/2007 UNIFIED PROGRAM INSPECTION CHECKLIST ~' r/tI ogram .SECTION 1: Business Plan and Inventory Pr BARERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME I / , NSQPE T\ION ATE NSPECTION TIME ' 'K'Q 1Q°4$ ~ `e 1 ~ W O d- ADDRESS HONE NO. O OF EMPLOYEES - FACILITY CONTACT ~ USINESS ID NUMBER 15-021- Section 1: ,Business Plan snd Inventory Program ^ ROUTINE OMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS APPROPRIATE PERMIT ON HAND qJ (~Cd ~ ~ ,`-~ ,~.~ I BUSIf1t3SS 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 PRO URES EMERGENCY PROCEDURES ADEQUATE _ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ^~N~O' EXPLAIN: - _ QUESTION EGARDI S INSPECTION? PLEASE CALL U8 AT (881) 328-3979 Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Stetion q Bus ss . White -Prevention Services Vallow -Station Copy Pink - t3uaineae Copy FD2049 (Rw.02/05) ~. + BAKERSFIEL Manager BusPhone: Location: 402 CALIFORNIA AVE Map 103 City BAKERSFIELD ~ Grid: 31B CommCbde: BFD STA 06 EPA Numb: SIC Code: DunnBrad: SiteID: 015-021-002875 + (661) 861-8900 CommHaz High. FacUnits: 1 AOV: Emergency Contact / Title Emergency Contact / Title / / Business Phone: ( ) - x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone _. ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth ----=----=r--==----==--= =---====----=---- ._ _ --- - =-~----~-------------------------=-------_=+ Contact Phone: (661) 861-8900x MailAddr: 402 CALIFORNIA AVE "State: CA City BAKERSFIELD Zip 93304 Owner ~Ay/~ AC~~ Phone: (661) 861-8900x Address 02 CALIFORNIA AVE State: CA City BAKERSFIELD ~ Zip 93304 Period to ~ TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: ~ RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT ~' . NOD ~~ ~~~~ ~~ Based on my inquiry of those individuals responsible for obtasning 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. ~-i~b6 ignature Date G'6/~ 3 ~(3- /yY~ ~M ~~ ITS ~ 55 A u.~ AdIJ~ AeZd~I~-- ----------- -1- 06/07/2006 ~~-~~ ~ BAKERBFIELD FIRE DEPT. . FIRE ORDINANCE VIOLATION: ' ~ B~ Lei' D Faeveation Services ' ~-~ ~~~ " 900 Trlaxturi Ave. Ste. 210 l~~ AlP1r® : d ,,,. " , " Bakersfield, CA 93301 ~~~ `" ~ Tel.: (661- 326-3979 X Fax: (661) 852-2171 OCCUPANCY DISTRICT • BLOCK N0. DATE r f '`-s ~ TO.1/~L~{~ ' ~~I TITLE ,,r~~ , ~ (/ FIRM OR OBA~A'~~./~~e~i~~°~ I.~ ..~Y 1.~./G A1.'TM.~l ,~'/i~" ~~ f~~~~~ ., ,r j~ a~~. COMPANY ADDRESS (CITY, STATE,21P)~~~ r* 1(! ,off BUSINESS PFIONE,~~~~~~~~ ~ G ~19MEA~H~O~~y~d..~ CORRECT ALL VIOLATIONS vwurroe CHECKED BELOW ro. REQUIREMENTS I DRY LE W 1 Remove and safely dispose of all hazardous refuse and dry vegetation,•on the above premises (U.F,:G'.)~ ~' ~°• e~" •' COMBUSTIB ASTE 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 arourid rnotor fuse box/fire door (N.E.C.) (U.F.CJ q .Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanginla on brackets with the top to the extinguisher not more than 5 feet above the floor. (N.F.P.A. No. 10) EXTINGUISHERS ,~, ~5 p t,,,/ Provide and install (amount~)~/''{~~approved (type & size) _~~ ~__~~~~__ portable fire extinguisher to be immediately accessible for use in (area) _~!./______ ~ (U.F.G.) 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 ~"'? (,;~ Provide and maintain °EXIT° sign(s) with letters 5 or more inches iri 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.) FJREDOORS/ RE S AT O g Repair all (crackslholes/openings) in plaster in (location) ______________~____~_______________. Plastering shall return the surface to its original fire resistive condition. (U.B.C.) FI EPAR I NS 10 Removelrepair (item & location) __ ___ __ _ __ _ _ ___ ____ ____________~_. Sett-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 19 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.G.) ELECrwcALAPPLUwces 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 tires or o en burnin U.F.C. FIREWORKS 17 Violations of Section7 802 U.F.C. or 8.49.040 of the Bakersfield Munici a) Code B.M.C. re ardin fireworks. OTHER ,J1~ ~^ ~ _~ ~f~~~L ,~' ~, ° ON (DATE) 0 ! ., rl'SP-.n~J, AN INSPECTK)N WILL BE MADE, IF NO COMPLUWCE HAS BEEN MADE, ADDITIONAL PERJION,RECEMNO NDtICE of VIOLATpN REGULATORY%-CTION MAY BE INITIATED. RC BYC AIL DN A D !" / t.f{.lV:. "`-x T~ - AFTER VIOLATIONS ARE CORRECTED, RETURN THIS NOTICE BY MAIL OR IN PERSON TO: BvORDEROF ~ FsiECHR:F .~ ,u, ~~ t..~~ Srf.~ .~^DA ~`~~r '/e~'_!._ BAKERSFIELD FIRE DEPT. OFFICE OF PREVENTION SERVICES 900 TRUXTUN AVE., SUITE 210 BAKERSFIELD, CA 83301 . ~ - WSPECTORSgNATURE ~ ~ LEGEND: aF.c. uwFORNU FIRE coDE usa uNIFDRIr auanlNO cODE e.M•c. aacERSFE:LD MUNICFAL CODE N.FPA NATIONAL FIRE PROTECTION A360CIATxk1 N.E.C. NATx1NAL ELECTRIC CODE wsFEOTDItswNATURE White -Customer/Original Yellow - Station Copy r~~.~ ~ Pink-Pr8v8ntiOnServiC6s i FD19181REV.02/Oti) - ~_ ~ r a~=~ FIRE ORDINANCE VIOLATION. ~iR~ I D ~~ ~ ~Rtr BAKERSFIELD FIRE DEPT. Prevention Services ~~ 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 X Fax: (661} 852-2171 OCCUPANCY ~ DISTRICT BLOCK NO. DATE / may/ TOJf~IJI'J i~ ./s'%'-~ .TREE ('~'W~'~~~~ FIRM OR D ~i~~~~~~~~~Lw~ ~ti~f"~...'L1~9...ra'1~~ COMPANY ADDRESS (CRY, STATE, ZIP) ~ ~~ / 1~~~ ,y~~ ~J G -/' /l" BUSINES8 PNQ ~~ g,~ ,,,ey~ L~ f./ ~!~ ~IAME•PMONE G"~~,r ,r CORRECT ALL VIOLATIONS vwurro CHECKED BELOW No. REQUIREMENTS ~~ ~ Remove and safely d'+spose of all hazardous refuse and dry vegetation :on the above premises (U.F.C.) COMBUSTIBLE WASTE /DRY VEGETATION 2 Provide non-combustible containers with tight fitting Ilds for the storage iif combustible waste and rubbish pending its safe disposal. (U.F.C.) i COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse boxffire 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) i EXTINGUISHERS t-5~ ~..5 Provide and install (amount)~"~~epproved (type 8 size) _ ~~~'=r~ ~~~ portable fire extinguisher to be immediately accessible for use in (area) _~__ ~ ~ ________~_~_~ (;U.F.G.) _ g ~I Re-charge allyfire 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 //'~~ ~ Provide and maintain'°EXIT° sign(s)'with letters 5 or more inches in height overreach required exit (door/viiindow) 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.) FJREl700RS1 g Repair all (cracks/holes/openings) in plaster in (location) __~___________~___~_______________. Plastering shall return the surface to its original fire resistive condition. (U.B.C.) FlRE SEPARATK)NS 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.) EXRS 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 1q 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 p•Iug per outlet) (N.E.C.) (U.F.C.) oUTDOORBURNING 16 Violation of Section 1102 dealin with recreational fires or o en burnin U.F.C. FlREYVORKS 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 1$ r~ I,~'ON (DATE) ll-~ f - YT AN INSPECTION WILL BE MADE, IF NO COMPLUWCE HAS BEEN MADE, ADDR10NA1 REGULATORYACTKNJ-MAY BE INR4-TED. ,,... rErtaoN qE ~ ' NOTICE of VIOlA7gN r '"~ ~ - /._Y ~ J - / - EN E T BY P N A D afaNATURE ..1 .',.""-`--" ,~ AFTER VIOLATIONS ARE CORRECTED, RETURN THIS NOTICE BY MAIL OR iN PERSON TO: ~'O~R~,rT~~~~ rhd' ~~~./~•~ ~'+f ~ ~ ~~~~j~~/}~'"'/"~ / '~=~f/"'C/~f BAKERSFIELD FIRE DEPT. OFFICE OF PREVENTION SERVICES 900 TRUXTUN AVE., SUITE 210 BAKERSFIELD, CA 83301 _ ~ ws~croasxlNnnce "- ~OEND` c.~.c. CALJFOItNtp FIRE coDE u.ac. uNiroalr eu~oao cooE ~' ~•G ~~~ rtuNlcwal voce NtPA. NATpNpLF6tEpROTEC71pN AS3pCpTgN N£C. NATpNgiEIFCTRIC CODE srow- . White -Customer/Original. Yellow -Station Copy r`, Pink -Prevention Services ~ i FD1818 (REV. o:rool