HomeMy WebLinkAboutBUSINESS PLAN 12/13/2006Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST H_ E R S F_, D 9oozi-uxtunAve., suite 210
~~~~~~ ~~ ~ ~~~~ ~-~~~ ~~ ~ FiRE....._ _ Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program ARTM r Tel.: (661) 326-3979
i _ ~ ~ Fax: (661) 872-2171
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FACILITY NAME INSPECTION DATE INSPECTION TIME
~ui1V ~~~i ~N i Z-13 -o6
ADDRESS
~-(5 5 a t.~~ p r o ~tJ ti R- .>4- ~ rte, PHONE NO.
3 3~t-y 800 NO OF EMPLOYEES
FACILITY CONTACT
K rz fY~ 'S l~ ~ 1~ BUSINESS ID NUMBER
15-021- DO 29 Zq
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Section 1: Business Plan and lnventary Program ~~~
ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ~ C=Compliance OPERATION
V=Violation COMMENTS
^ APPROPRIATE PERMIT ON NAND - ~-~
^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ~ /' 1 5 ~oo
l~
^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY ~~(~ Cv ~ P• /~ ~ N'~-~Q
C~ w•-
^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
~,/
L~ ^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
- /
C!' ^ VERIFICATION OF MSDS AVAILABILITY
^ VERIFICATION OF HAZ MAT TRAINING
l~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
C~ ^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ^YES I~d~N~
FXPI GIN
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QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
~.
- Inspector (Please Print) Fire Prevention / 1~` In /Shift of Site/Station # uslness Site / espo le Pa y (Please Pril )
White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05
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+ MERVYNS _____________________________________________ SiteID: 015-021-001425 +
Manager
Location: 4450 CALIFORNIA AVE
City BAKERSFIELD
BusPhone: (661) 327-4101
Map 102 CommHaz Low
Grid: 35A FacUnits: 1 AOV:
CommCode: BFD STA 11
EPA Numb:
SIC Code:5699
DunnBrad:
Emergency Contact J Title Emergency Contact / Title
YOLANDA LEGRO / STORE MANAGER JIM POMATTO /
Business Phone: (661) 32'T-4101x Business Phone: (661) 327-4101x241
2 4 -Hour Phone ( 6 61) 7 0 3' - 5 7 9 9x 2 4 -Hour Phone ( 6 61) ~4~Er3~9~
Pager Phone ( ) - x Pager Phone ( ) 9~~ - ~~ `'~ ~ x
Hazmat Hazards:
Contact ROBERT H LUCACHE~t Phone: (510) 727-3237x
MailAddr: 22301 FOOTHILL BLVD MS4025 State: CA
City HAYWARD Zip 94541
Owner MERVYNS LLC Phone: (510) 727-3000x
Address 22301 FOOTHILL BLVD State: CA
City HAYWARD Zip 94541
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
~ Emergency Directives: ~
PROG A - HAZMAT
PROG T - UNDERGROUND STORAGE TANK
a ` '' ~~~~, i al LU~U
~~~
Based 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.
~~ _ ~ ~o
Signature Date
-1- 03/02/2006