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Home My WebLink AboutBUSINESS PLANt T ~ ',' JIFFY LUBE 1726 (CALIFORNIA) Manager ADOLFO LARIOS Location: 3208 CALIFORNIA AVE City BAKERSFIELD SiteID: 015-021-002226 BusPhone: (661) 859-0183 Map 102 CommHaz Low Grid: 35B FacUnits: 1 AOV: CommCode: BFD STA 03 EPA Numb: SIC Code:7538 DunnBrad:33-0518793 Emergency Contact / Title Emergency Contact / Title ADOLFO LARIOS / MANAGER STEVE SHIELDS / DIRECTOR Business Phone: (661) 859-0183x Business Phone: (310) 831-1043x 24-Hour Phone (661) 871-3841x 24-Hour Phone (310) 384-9066x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire DelHlth Contact : '. S~vE S~tEL.~$ Phone: (310) 831-1043x MailAddr: 595 W 7TH-ST 202. State: CA City SAN PEDRO Zip 90731 Owner PEPPERTREE INC Phone: (310) 831-1043x Address 595 W 7TH ST 202 State: CA City SAN PEDRO Zip 90731 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK EN7"D ~ ~ B ~ ~ 2007 Based on my inquiry of thosa lndivld~als responsible for obtaining the infgrmr3tign, I eertifiy under penalty of Raw that I have personally examined a fami-iar with the information subm'' d and ~lisve the information is true, a r ~ mplete ~, ~, ~~ ~ ~ i ture Date -1- 02/01/2007 ;• F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE OIL F DH L 1050.00' GAL Low TRANSMISSION FLUID F DH L 759.00 GAL Low WASTE ANTIFREEZE F DH L 165.00 GAL Low ANTIFREEZE L 165.00 GAL Low MOTOR OIL F DH L 2440.00 GAL Min -2- 02/01/2007 -3- 02/01/2007 r F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ F= Inventory Item 0.005 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facilit Unit Ma Grid y p: : BASEMENT CAS# 221 LiTAid Waste qu' T AmbRentURE TEMPERATURE -~ ~ Ambient CONTAINER TYPE ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1050.00 GAL 1050.00 GAL 500.00 GAL HAZARDOUS COMPONENTS oWt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 I1HGL-iRL HJ ~7~~iJl•1P~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low F= Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME TRANSMISSION FLUID Days On Site 365 Location within this Facility Unit Map: Grid: AST CAS# 0 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 759.00 GAL 759.00 GAL I 400.00 GAL Wt ° rinurucLVVa L.V1•lr V1V L~1V1S _ s . RS CAS# 100.00 Transmission Fluid (Petroleum-Based) No 0 17tiL~tiiCL H. 7 w7.G.7 Jl•1L~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -4- 02/01/2007 F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE ANTIFREEZE - Days On Site 365 Location within this Facility Unit Map: Grid: DUMPSTER ENCL ~ CAS# 107-21-1 Liquid TWaste -~mbRent~E ~ AmbientT~E ~ PLASTICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 165.00 GAL _ 165.00 GAL rlti~r-ucLVU~ ~vi~irvlVl,iV1~ %Wt. RS CAS# 30.00 Ethylene Glycol No 107211 t11~Gt11[L 1~5.7t5w7~lY1L' 1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit Map:. Grid: DUMPSTER ENCL CAS# STATE TYPE PRESSURE TEMPERATURE ~~~ CONTAINER TYPE Liquid TMixture ~mbient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 165.00 GAL 165.00 GAL l1t~GKRLVUa7 l.VP7YVIVLSIV 1.7 %Wt. RS CAS# 100.00 Ethylene Glycol No 107211 I11iGKKL H J 71:,.7.71~1.C~1V 1 .7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -5- 02/01/2007 ' F JIFFY LUBE 1726 (CALIFORNIA) ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit BASEMENT STATE TYPE PRESSURE Liquid TMixture ~ Ambient SiteID: 015-021-002226 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 8020835 TEMPERATURE CONTAINER TYPE Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1066.00 GAL 2440.00 GAL , 1000.00_ GAL t1t~GE1ttLV U5 1:V1~lYV1VL'~1V l"J %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 tiAGLitt1J 1'i5~r;~~1~11;1V 1"5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -6- 02/01/2007 F_JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 Fast Format ~ Notif./Evacuation/Medical ~ Overall Site ~ Agency Notification 04/11/2006 TANKS AND BARBELLS ARE VISIBLE AND INSPECTED DAILY. CONCRETE BERMS PROVIDE SECONDARY CONTAINMENT. WASTE OIL IS RETAINED IN DOUBLE-WALLED TANK AND BASEMENT IS SEALED. WASTE OIL TANK HAS OVERFILL WARNING WHISTLE. Employee Notif./Evacuation 04/11/2006 EMPLOYEES ARE NOTIFIED VERBALLY. THIS IS A SMALL 2700 FT FACILITY WHERE A SINGLE WARNING IS HEARD BY ALL. IN THE EVENT OF A SERIOUS SPILL, ANYONE CALLS 911. GENERAL MANAGER CONTACTS REGIONAL MANAGER AT 310- AND OFFICE OF EMERGENCY SERVICES AT 800-852-7550. NON-EMERGENCY SP LL, REGIONAL MANAGER CALLS 661-326-3979. 92o-G~i~ Public Notif./Evacuation 04/11/2006 GENERAL MANAGER AND ASSISTANT MANAGER HANDLE ROUTINE SPILLS. SPILL ON-SITE. CLEAN-UP IS HANDLED BY ASBURY ENVIRONMENTAL SERVICES AT 800-974-4495. REGIONAL MANAGER AND/OR DIRECTOR AT 310-831-1043 WILL COMPLETION. KITS ARE ASSURE Emergency Medical Plan 04/11/2006 CALL 911. IF SYSTEM IS DOWN, CONTACT MERCY HOSPITAL, 632-5000, 2215 TRUXTUN AVE OR MERCY OCCUPATIONAL CENTER AT 632-5000. MERCY OCCUPATIONAL CENTER, 400 OLD RIVER RD, 632-5050 -7- 02/01/2007 F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 04/11/2006 ABSORBANT IS KEPT ONSITE FOR MINOR SPILLS. TANKS ARE INSPECTED DAILY. ONLY HAZ SUBSTANCE IS WASTE OIL STORED IN DOUBLE-WALLED TANKS WITH AUDIBLE WARNING IN EVENT OF OVERFILL. Release Containment 04/11/2006 SEALED BASEMENT, DOUBLE-WALL TANKS FOR WASTE OIL, CONCRETE BERMS FOR CONTAINMENT, DAILY INSPECTION AND HOUSEKEEPING ELIMINATE POSSIBILITY OF RELEASE BEYOND WALLS OF LOWER LEVEL. Clean Up 04/11/2006 = ~1 I?-a Im A2K MINOR SPILLS (SPOTS) CLEANED WITH RAGS, SERVICED BY.~~rE. SPILL KITS ONSITE WHICH CAN BE STORED IN SEALED BARBELLS AND REMOVED BY ASBURY ENVIRONMENTAL SERVICES. WASTE IS REMOVED EVERY TWO WEEKS. Other Resource Activation -8- 02/01/2007 F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JeC:.LCl1 nc«arus Utility Shut-Offs 02/,01/2007 A) GAS - NE CRNR OF BLDG B) ELECTRICAL - NE CRNR OF BLDG (w ~~,~ C) WATER - S SIDE OF BLDG AT MAIN ENTRY DOOR D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 02/01/2007 4 FIRE EXTINGUISHERS: GROUND LEVEL AND IN PIT. NEAREST FIRE HYDRANT - SIDEWALK AT CALIFORNIA AVE FRONT OF BLDG S SIDE. Building Occupancy Level 12/07/2006 9 EMPLOYEES -9- 02/01/2007 ~/ ~; ,' %F-JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ Fast Format ~ ~ Training Overall Site ~ ~~ Employee Training 02/01/2007 ~ MSDS SHEETS ON FILE AT STORE IN RED IIPP MANUAL. BRIEF SUMMARY OF TRAINING PROGRAM: THE TRAINING PROGRAM CONTAINS, IN PART: ORIENTATION VIDEO; IIPP; BI-WEEKLY SAFETY MEETINGS; AND CERTIFICATION PROGRAMS WITH STUDY GUIDES, VIDEOS, WORKBOOKS AND-WRITTEN EXAMINATIONS.' rayc c. nclu Lvt r ul.ulC USC r1Clu 1V1. t'UI.uIC U.y'C -10- 02/01/2007 i %T JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 Manager ADOLFO LARIOS Location: 3208 CALIFORNIA AVE City BAKERSFIELD CommCode: BFD STA 03 EPA Numb: BusPhone: (661) 859-0183 Map 102 CommHaz Low Grid: 35B FacUnits: 1 AOV: SIC Code:7538 DunnBrad:33-0518793 Emergency Contact / Title Emergency Contact / Title `ti ADOLFO LARIOS / MANAGER STEVE SHIELDS / CfR ~ dd Business Phone: (661) 859-018 3x Business Phone: ( 10) 831-1043x ,/ 24-Hour Plione (661) 871-384 1x ~ 24-Hour Phone (3\10) 384-9066x/ Pager Phone ( ) - x Pager Phone ( ~)~,,•-x Hazmat Hazards: Fire DelHlth Contact STEVE SHIELDS Phone: (310) 831-1043x MailAddr: 595 W 7TH ST 202 State: CA City SAN PEDRO Zip 90731 Owner PEPPERTREE INC Phone: (310) 831-1043x Address 595 W 7TH ST 202 State: CA City SAN PEDRO Zip 90731 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs:- No ParcelNo: , Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ~~ PROG T - ABOVEGROUND STORAGE T ANK ~~ JUG ~ ~ pRRq ~~U/ 3asod on my inq;.?iry of those individuals responuibi s ' taining the information, I certify under analty f law that I have personally s fi d ,. ne and familiar with the information ubmitted an belie thg.in` tion is true, ~~ I ''~r~, ' Y ~/vim v -- nature Date ~-~,. / -1- 07/12/2007 4 ~ ~. F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE OIL F DH L 1050.00 GAL Low TRANSMISSION FLUID F DH L 759.00 GAL Low WASTE ANTIFREEZE F DH L 165.00 GAL Low ANTIFREEZE L 165.00 GAL Low MOTOR OIL F DH L 2440.00 GAL Min -2- 07/12/2007 f=~ -3- o~/la/aoo~ z F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ ~ 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: BASEMENT CAS# 221 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWasteAmbient ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest -Container Daily Maximum Daily Average 1050.00 GAL 1050.00 GAL 500.00 GAL ' t1N~GH.IC.UVUA 1.U1~lYU1VI;1V 1.7 %Wt. RS CAS# I 100.00 Waste Oil, Petroleum Based No 0 t1AGKKIJ E~J~1;~~1~11;1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME TRANSMISSION FLUID Location within this Facility Unit AST STATE TYPE PRESSURE Liquid Mixture ~ Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 0 TEMPERATURE CONTAINER TYPE _ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 759.00 GAL 759.00 GAL 400.00 GAL L1HGE'1CCLVU.7 1.V1~lYUlV~1V 1.7 oWt. RS CAS# 100.00 Transmission Fluid (Petroleum-Based) No 0 riHGKKL HJ~~~~1~11;1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -4- 07/12/2007 F JIFFY LUBE 1726 (CALIFORNIA) ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE ANTIFREEZE Location within this Facility Unit DUMPSTER ENCL STATE TYPE PRESSURE Liquid TWaste ~mbient SiteID: 015-021-002226 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 107-21-1 TEMPERATURE CONTAINER TYPE Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 165.00 GAL 165.00 GAL ••- tlr~~r~tcl.~vu~ uvrirviV~1V 1 %Wt. RS CAS# 30.00 Ethylene Glycol No 107211 riHGAKL A~~t5~51~1L'1V15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME ANTIFREEZE Location within this Facility Unit DUMPSTER ENCL Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE Liquid Mixture ~ Ambient TEMPERATURE CONTAINER TYPE Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 165.00 GAL 165.00 GAL riKGL-1[CLIVUJ l.Vl"lYV1VtS1V1J %Wt. RS CAS# 100.00 Ethylene Glycol No 107211 rlt•~atucl~ r~~ ~l;~al~lr.ty 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -5- 07/12/2007 i. F JIFFY LUBE 1726 (CALIFORNIA) ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit BASEMENT STATE TYPE PRESSURE Liquid TMixture ~mbient SiteID: 015-021-002226 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 8020835 TEMPERATURE CONTAINER TYPE Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest--Container Daily Maximum Daily Average 1066.00 GAL 2440.00 GAL 1000.00 GAL rlti~rjxl~~u~ ~~l~ir~lv~lv'1'S %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 Y1A"L,1]lt1J A55~SS1~1lilV'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -6- 07/12/2007 F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 04/11/2006 TANKS AND BARBELLS ARE VISIBLE AND INSPECTED DAILY. CONCRETE BERMS PROVIDE SECONDARY CONTAINMENT. WASTE OIL IS RETAINED IN DOUBLE-WALLED TANK AND BASEMENT IS SEALED. WASTE OIL TANK HAS OVERFILL WARNING WHISTLE. Employee Notif./Evacuation 02/27/2007 EMPLOYEES ARE NOTIFIED VERBALLY. THIS IS A SMALL 2700 FT FACILITY WHERE A SINGLE WARNING IS HEARD BY ALL. IN THE EVENT OF A SERIOUS SPILL, ANYONE CALLS 911. GENERAL MANAGER CONTACTS REGIONAL MANAGER AT 310-920-6615 AND OFFICE OF EMERGENCY SERVICES AT 800-852-7550. NON-EMERGENCY SPILL, REGIONAL MANAGER CALLS 661-326-3979. 9 9 Public Notif./Evacuation 04/11/2006 GENERAL MANAGER AND ASSISTANT MANAGER HANDLE ROUTINE SPILLS. SPILL ON-SITE. CLEAN-UP IS HANDLED BY ASBURY ENVIRONMENTAL SERVICES AT 800-974-4495. REGIONAL MANAGER AND/OR DIRECTOR AT 310-831-1043 WILL COMPLETION. KITS ARE ASSURE Emergency Medical Plan 04/11/2006 CALL 911. IF SYSTEM IS DOWN, CONTACT MERCY HOSPITAL, 632-5000, 2215 TRUXTUN AVE OR MERCY OCCUPATIONAL CENTER AT 632-5000. MERCY OCCUPATIONAL CENTER, 400 OLD RIVER RD, 632-5050 -7- 07/12/2007 F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/11/2006 ~ ABSORBANT IS KEPT ONSITE FOR MINOR SPILLS. TANKS ARE INSPECTED DAILY. ONLY HAZ SUBSTANCE IS WASTE OIL STORED IN DOUBLE-WALLED TANKS WITH AUDIBLE WARNING IN EVENT OF OVERFILL. Release Containment 04/11/2006 SEALED BASEMENT, DOUBLE-WALL TANKS FOR WASTE OIL, CONCRETE BERMS FOR CONTAINMENT, DAILY INSPECTION AND HOUSEKEEPING ELIMINATE POSSIBILITY OF RELEASE BEYOND WALLS OF LOWER LEVEL. Clean Up 02/27/2007 MINOR SPILLS (SPOTS) CLEANED WITH RAGS, SERVICED BY AR.AMARK. SPILL KITS ONSITE WHICH CAN BE STORED IN SEALED BARBELLS AND REMOVED BY ASBURY ENVIRONMENTAL SERVICES. WASTE IS REMOVED EVERY TWO WEEKS. v~iici. ncavulvc til.l.lV0.l~1V11 -8- 07/12/2007 F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aNc~.~.a.L nac~atu~ Utility Shut-Offs 02/27/2007 A) GAS - NE CRNR OF BLDG B) ELECTRICAL - NE CRNR OF BLDG IN BAY C) WATER - S SIDE OF BLDG AT MAIN ENTRY DOOR D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 02/01/2007 4 FIRE EXTINGUISHERS: GROUND LEVEL AND IN PIT. NEAREST FIRE HYDRANT - SIDEWALK AT CALIFORNIA AVE FRONT OF BLDG S SIDE. Building Occupancy Level 12/07/2006 9 EMPLOYEES -9- 07/12/2007 . ~~ F JIFFY LUBE 1726 (CALIFORNIA) SiteID: 015-021-002226 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training 02/27/2007 MSDS SHEETS ON FILE AT STORE IN RED IIPP MANUAL. BRIEF SUMMARY OF TRAINING PROGRAM: THE TRAINING PROGRAM CONTAINS, IN PART: ORIENTATION VIDEO; IIPP; BI-WEEKLY SAFETY MEETINGS; AND CERTIFICATION PROGRAMS WITH STUDY GUIDES, VIDEOS, WORKBOOKS, WRITTEN EXAMINATIONS, AND ' COMPUTER-BASED EXAMINATION. rayC ~ 11c 11.L 1V1. t'ul.ulC V~7-C azciu ivt rUI.uLC U~S'C -10- 07/12/2007 UNIFIED PROGRAM INSPECTION CHECKLIST _ _ _ _ -- _ SECTION 1: Business Plan and Inventory Program 1 Prevention Services B_ e R__5 F_! 0 900 Truxtun Ave., Suite 210 F/RE Bakersfield, CA 93301 ARTM T Tel..: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME -~ - ~ ~ ~~ / y~ / INSPE TION D ~E~ INSPECTIO~IME ADDRESS ~ ^ ~~~/~ ^ ~~ /V'rllj,`/'1/ /nJ, P „ NE ~~` ~ I / NO OF EM OYEES FACILITY CONTACT ~O~ L,~rp-tO5 B SINESS ID NU M BER 15-021-(~ ~,2?~v Sec#ion 1: Business Plan and Inventory Program ,~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS NT'D DEC 0 6 2006 ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION /1 V ^ PROPER SEGREGATION OF MATERIAL O ^ VERIFICATION OF MSDS AVAILABILITY O ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARD~O~U~S,~WASTE ON SITEv~~~~~~``~~r 1~'YES ^ NO EXPLAIN: `-""' "^-'~ Gl ~ ~ LALILLI.L~ 17Q~ ~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1~` In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 UNIFIED PROGRAM INSPECTION CHECKLIST; SECTION 1; Business Plan and Inventory Program BAKERSFIELD FIRE DEPT to apt D Prevention Services rfRl 900 Tnixtun Ave., Suite 210 ~a>r>rM t Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECTI N DATE INSPECTION TIME ADDRESS ~ ^ _ (~ HO ~ ~ O OF EM OYEES FACILITY CONTA T' l.~rrl ~1 ~4 V ~~ USINESS ID NUMBER 15-021- Q622~ Section 1: Business Plan and Inventory Program ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=Compliancee OPERATION V=Violation COMMENTS L9' ^ APPROPRIATE PERMIT ON HAND (~ ^ BUSIn@SS PLAN CONTACT INFORMATION ACCURATE LET ^ VISIBLE ADDRESS ~ ^ CORRECT OCCUPANCY CC /7 - ,/ is ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~ ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY g/ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES Cad ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING h~Y ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES LET NO .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 3 ~~ Inspector (Pleas Print) Fire Prevention / 1s' In /Shift of Site/Station # Busin i /Sch ite Responsible Party (Please Print) ~I ~ ~~~ White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02/05) ~~, ~'; + JIFFY LUBE __________________________________________ SiteID: 015-021-002226 + Manager ADOLFO LARIOS Location: 3208 CALIFORNIA AVE City BAKERSFIELD BusPhone: (661) 859-0183 Map 102 CommHaz :'Low Grid: 35B FacUnits: 1 AOV: CommCode: BFD STA 03 SIC Code:7538 EPA Numb: DunnBrad:33-0518793 Emergency Contact / Title Emergency Contact / Title ADOLFO LARIOS / MANAGER STEVE SHIELDS / DIRECTOR Business Phone: (661) 859-0183x Business Phone: (310) 831-1043x 24-Hour Phone (661} 871-3841x 24-Hour Phone (310) 384-9066x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire DelHlth Contact Phone: (310) 831-1043x MailAddr: 595 W 7.TH ST 202; State: CA City SAN PEDRO Zip 90731 Owner PEPPERTREE INC DBA JIFFY LUBE Phone: (310) 831-1043x Address 595 W 7TH ST 202'' State: CA City. SAN PEDRO Zip 90731 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK ENT°D APR 1 ~. 2006 Eiased on my inquiry of those individuals responsible for obtaining the information, I ce-tify under pe of law that I have personally exami and m familiar with the information s fitted d be ' t~mation is true ~I ~ `/ /~ -1- 03/02/2006