Loading...
HomeMy WebLinkAboutBUSINESS PLAN 7/12/2007ii ADVANCE BEVERAGE CO., INC.. A I~ 5200 DISTRICT BLVD. J ADVANCE BEVERAGE CO INC Manager WILLIAM K LAZZERINI JR Location: 5200 DISTRICT BLVD City BAKERSFIELD SiteID: 015-021-000298 BusPhone: (661) 833-3783 Map 123 CommHaz Low Grid: 15D FacUnits: 1 AOV: CommCode: BFD STA 13 EPA Numb: SIC Code:5149 DunnBrad: Emergency Contact / Title Emergency Contact / Title WILLIAM K LAZZERINI / PRESIDENT JERRY MASON / OPS MANAGER Business Phone: (661) 833-3783x103 Business Phone: (661) 833-3783x165 24-Hour Phone (661) 834-5485x 24-Hour Phone (661) 871-7431x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact TODD MASSEY Phone: (661) 833-3782x MailAddr: PO BOX 9517 State: CA City BAKERSFIELD Zip 93389-9517 Owner WILLIAM K LAZZERINI JR Phone: (661) 834-5485x Address 7609 CALLE CERCA State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ~Nro JuL ~ 3 2007 fatted on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that 1 have personalty examined and am familiar with the information submitted and believe the information is true, accurate, and c lete. ~7 ~ ~ re Date -1- 06/29/2007 ,1 F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE OIL F DH L 300.00 GAL Low CO2 F P IH G 3400.00 FT3 Min MOTOR OIL F DH L 450.00 GAL Min NITROGEN F P IH G 275.00 FT3 Min -2- 06/29/2007 -3- 06/29/2007 F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 221 Liquid TWaste ~ AmbRent~E ~ AmbientT~E OTHERONTSPECIFYYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 150.00 GAL 300.00 GAL 150.00 GAL rlti~tilcl.~vu~ wlnr~iv~iv l~a %Wt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 t1AGA1CL HJ5~.751~1t51V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME CO2 Location within this Facility Unit DRAFT RM S OF WHSE A STATE TYPE PRESSURE _ Gas Pure Above Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 128-38-9 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest C1700100rFT3 Daily3400100m FT3 I Daily1700r00e FT3 I1HG1•i.['CLVU~J ~.V1~lYV1Vr+1V 1 ~ %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 tl!-1GE'l1CL 1~~7 A L" .7 J1~1L' 1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -4- 06/29/2007 F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: NW CRNR SHOP FUEL ISLAND NW TRUCK WELL CAS# STATE T TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid I Mixture ~ Ambient ~ Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 225.00 GAL 450.00 GAL 225.00 GAL HAZARDOUS COMPONENTS aWt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 t1E~L,Ell{L AS ~li~~1~1L'~1V"1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME NITROGEN Location within this Facility Unit DRAFT RM S OF WHSE A STATE TYPE PRESSURE _ Gas TPure ~-Above Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7727-59-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Co135100rFT3 Daily 275100m FT3 I Daily 135r00e FT3 • riliL~H2CLVUJ 1.V1~lYV1V~1V1.7 °sWt. RS CAS# 100.00 Nitrogen No 7727379 t11~G1~tCL L•~b A~AJ1~1~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 06/29/2007 F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 12/06/1999 FIRE DEPARTMENT AND COUNTY HEALTH DEPARTMENT. Employee Notif./Evacuation _ 12/06/1999 IF NECESSARY, FACILITY CAN BE EVACUATED BY A PAGING SYSTEM. WAREHOUSE MANAGER OR SHIFT SUPERVISORS ARE RESPONSIBLE FOR DIALING 911. Public Notif./Evacuation 09/22/2006 CUSTOMER WILL NOT BE AFFECTED BY ANY ON-SITE EMERGENCY. NOTIFICATION OF BUSINESSES THAT ARE AFFECTED WILL BE MADE BY PHONE OR IN PERSON. Emergency Medical Plan 09/22/2006 MEDICAL EMERGENCIES ARE REPORTED IMMEDIATELY TO A SUPERVISOR WHO HAS BEEN INSTRUCTED TO EITHER DIAL 911, OR, IF MINOR, TO TRANSPORT TO A MEDICAL FACILITY. MOST HOSPITALS IN TOWN ARE CAPABLE OF HANDLING MOST EMERGENCIES WE MAY ENCOUNTER . - ' - -PRA T~ vr -a4t3~-HWES'i'-AGEN'T' r..-.m.~p~-T,T /~ b ~ ~ My C''` 1~ J rrS r nr~S -6- 06/29/2007 F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 09/22/2006 ~ A NO SMOKING POLICY NEAR HAZARDOUS MATERIALS IS STRICTLY ENFORCED. NO SMOKING SIGNS ARE POSTED CLEARLY. GREASE RAGS ARE PROPERLY STORED AFTER USE. THE SHOP IS CLEANED DAILY AND A LAUNDRY SERVICE PICKS UP SOILED RAGS WEEKLY. GAS CYLINDERS ARE SECURELY CHAINED. WARNING AND HANDLING INSTRUCTIONS ARE POSTED IN STORAGE AREA. Release Containment 02/22/2007 SPILL KIT Clean Up MP ENVIRONMENTAL SERVICES, 3400 MANOR ST, BAKERSFIELD CA 93308. 02/22/2007 Other Resource Activation -7- 06/29/2007 F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ a~c~iai nac.aiu.a Utility Shut-Offs 06/28/2006 A) GAS - SE CRNR OF OFFICE B) ELECTRICAL - SW CRNR OF WHSE C C) WATER - TWO MAINS W OF WHSES B & C D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 09/22/2006 PRIVATE FIRE PROTECTION - OVERHEAD SPRINKLERS THROUGHOUT THE FACILITY, FIRE HOSES, AND FIRE EXTINGUISHERS ARE READILY AVAILABLE IN ALL LOCATIONS. THREE ARE LOCATED ON THE WEST SIDE OF GRISSOM AND ONE AT EACH GATE ENTRANCE. FIRE HYDRANT - 2 ON S SIDE OF DISTRICT BLVD. Building Occupancy Level 115 EMPLOYEES 03/14/2006 -8- 06/29/2007 !~ .~ , F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 09/22/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY MEETINGS ARE HELD ON AN ONGOING PROCESS. MEETINGS ARE HELD ON AN EVERY OTHER MONTH SCHEDULE. rayc c. Held for Future Use nciu tvi rutruic vcc -9- 06/29/2007 ~ !S_ K'- ADVANCE BEV/~ERAGE CO/SIN/C SiteID: 015-021-000298 Manager //t/ ~I~r~'`' f`- L-~ZZL!' ~ N~ Bus Phone : ( 6 61) 8 3 3 - 3 7 8 3 Location: 5200 DISTRICT BLVD Map 123 CommHaz Low City BAKERSFIELD Grid: 15D FaCUnits: 1 AOV: CommCode: BFD STA 13 EPA Numb: SIC Code:5149 DunnBrad: Emergency Contact / Title Emergency Contact / Title WILLIAM K LAZZERINI / PRESIDENT JERRY MASON / OPS MANAGER Business Phone: (661) 833-3783x103 Business Phone: (661) 833-3783x165 24-Hour Phone (661) 834-5485x 24-Hour Phone (661) 871-7431x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact ~ ~U ~-SS~~ Phone: (661) 833-3782x MailAddr: PO BOX 9517 State: CA City BAKERSFIELD Zip 93389-9517 Owner WILLIAM K LAZZERINI JR Phone: (661) 834-5485x Address 7609 CALLE CERCA State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: ~ RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ENT F ~~ aa3~e ~t~ tii~ inquiry of those individuals 2 2 ~QQ, responsible #~r dbt€tlnln~ the Information, I a®rtify under penalty of law that I have personally examined and am familiar with the information submitted and bell®ve the information is true, accurat , ~ d compiet ,. ~~ /~S^^ig~~., / Date -1- 01/24/2007 F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE OIL F DH L 300.00 GAL Low CO2 F P IH G 3400.00 FT3 Min MOTOR OIL F DH L 450.00 GAL Min NITROGEN F P IH G 275.00 FT3 Min -2- 01/24/2007 ~, -3- 01/24/2007 P :,_ F ADVANCE BEVERAGE CO INC ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME WASTE OIL Location within this Facility Unit STATE TYPE PRESSURE Liquid TWaste -Ambient SiteID: 015-021-000298 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 221 TEMPERATURE CONTAINER TYPE Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Co150100rGAL Daily 300100m GAL ~ Daily 150r00e GAL - t1AGHtCLVU~ lLV1°lYV1VL'1V1~ oWt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 t1L~GHKL L~.S~J;~~1~1~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CO2 Days On Site 365 Location within this Facility Unit Map: Grid: DRAFT RM S OF WHSE A CAS# 128-3$-9 ~GasATE T TYPE '~(~ PRESSURE TEMPERATURE CONTAINER TYPE I Pure I Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1700.00 FT3 3400.00 FT3 1700.00 FT3 r1t~~s~tcLVUa ~V1~irVlv~lvl~ %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 t1E~GE~I<L 1~.7 .7L" 5.71~11;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -4- 01/24/2007 F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: NW CRNR SHOP FUEL ISLAND NW TRUCK WELL CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~mbient ~ Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average _ 225.00 GAL 450.00 GAL 225.00 GAL riE~GKtCLVU~ 1:V1~lYV1Vt51Vl~ oWt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 ril-~GHKL HJ.7L' .7.71~1L" 1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME NITROGEN Days On Site 365 Location within this Facility Unit Map: Grid: DRAFT RM S OF WHSE A CAS# 7727-59-7 STATE T TYPE PRESSURE ~ TEMPERATURE ~~ CONTAINER TYPE ~ ~Ga.S I Pure Above Ambient I Ambient I PORT_ PRESS_ CYLINDER I AMOUNTS AT THIS LOCATION Largest Co135100rFT3 Daily 275100m FT3 I Daily 135r00e FT3 ruy~ru~LV~J ~.Vi~1rV1vr~1v1S %Wt. RS CAS# 100.00 Nitrogen No 7727379 I1tiL~tiiCL Hw 7 JP~.7 w71~1J;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 01/24/2007 _ ;, F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 12/06/1999 FIRE DEPARTMENT AND COUNTY HEALTH DEPARTMENT. 9 Employee Notif./Evacuation 12/06/1999 IF NECESSARY, FACILITY CAN BE EVACUATED BY A PAGING SYSTEM. WAREHOUSE MANAGER OR SHIFT SUPERVISORS ARE RESPONSIBLE FOR DIALING 911. Public Notif./Evacuation 09/22/20.06 CUSTOMER WILL NOT BE AFFECTED BY ANY ON-SITE EMERGENCY. NOTIFICATION OF BUSINESSES THAT ARE AFFECTED WILL BE MADE BY PHONE OR IN PERSON. Emergency Medical Plan MEDICAL EMERGENCIES ARE REPORTED IMMEDIATELY TO INSTRUCTED TO EITHER DIAL 911, OR, IF MINOR, TO FACILITY. MOST HOSPITALS IN TOWN ARE CAPABLE OF WE MAY ENCOUNTER. WE ALSO ARE IN THE PROXIMITY MING AND ASHE. 09/22/2006 A SUPERVISOR WHO HAS BEEN TRANSPORT TO A MEDICAL HANDLING MOST EMERGENCIES OF SOUTHWEST URGENT CARE AT -6- 01/24/2007 ~y ~ 1 F ADVANCE BEVERAGE CO INC SiteID: 015-021-00029$ ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 09/22/2006 ~ A NO SMOKING POLICY NEAR HAZARDOUS MATERIALS IS STRICTLY ENFORCED. NO SMOKING SIGNS ARE POSTED CLEARLY. GREASE RAGS ARE PROPERLY STORED AFTER USE. THE SHOP IS CLEANED DAILY AND A LAUNDRY SERVICE PICKS UP SOILED RAGS WEEKLY. GAS CYLINDERS ARE SECURELY CHAINED. WARNING AND HANDLING _ INSTRUCTIONS ARE POSTED IN STORAGE AREA. Release Containment 3 yvo ~w~~ S~<<~ ~G/~G/S ~~'C /c~~ ~~ , %,~3oC3 V1.11Ct 1CC.5"VULC:C t1C~l.1VdL1V11 -7- 01/24/2007 .~.... F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards Utility Shut-Offs A) GAS - SE CRNR OF OFFICE B) ELECTRICAL - SW CRNR OF WHSE C C) WATER - TWO MAINS W OF WHSES B & C D) SPECIAL - NONE E) LOCK BOX - NO 06/28/2006 Fire Protec./Avail. Water 09/22/2006 PRIVATE FIRE PROTECTION - OVERHEAD SPRINKLERS THROUGHOUT THE FACILITY, FIRE HOSES, AND FIRE EXTINGUISHERS ARE READILY AVAILABLE IN ALL LOCATIONS. THREE ARE LOCATED ON THE WEST SIDE OF GRISSOM AND ONE AT EACH GATE ENTRANCE. FIRE HYDRANT - 2 ON S SIDE OF DISTRICT BLVD. Building Occupancy Level 115 EMPLOYEES 03/14/2006 -8- 01/24/2007 ~,, ;, . F ADVANCE BEVERAGE CO INC SiteID: 015-021-000298 ~ Fast Form~.t ~ ~ Training Overall Site ~ ~ Employee Training 09/22/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY MEETINGS ARE HELD ON AN ONGOING PROCESS. MEETINGS ARE HELD ON AN EVERY OTHER MONTH SCHEDULE. rciyc ~ nciu tv.~ ru~.uic vac nci~.a i.vi r u~uic vac -9- 01/24/2007 UNIFIED PROGRAM INSPECTION CHECKLIST~~' .SECTION 1: Business Plan and Inventory Program BARERSFIELD FIRE DEPT a Prevention Services rwlt~ 900 Truxtun Ave., Suite 210 ~R>rr Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE INSPECTION TIME c. - h,P N d D ADDRESS HONE NO. O OF EMPLOYEES ~~d ~v 833-37$~ a~~ FACILITY CONTACT USINESS ID NUMBER ,-' ~ ~ ~ /~ Z Z f 15-021- ODU~ 9 ~ , . . tN l _Section 1_Business Plan and Inventory Program _ ~-gg~ - ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION • C V (c=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~. ^ BUSIf'2@SS PLAN CONTACT INFORMATION ACCURATE l~ ^ VISIBLE ADDRESS r ^ CORRECT OCCUPANCY ~oo~ C~ ^ / VERIFICATION OF INVENTORY MATERIALS ~ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ L~ ^ / PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY --- O -- t _ .__.. - - - -~------- - O\ ~ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND ROCEDURES I~ ^ / EMERGENCY PROCEDURES ADEQUATE ~ D CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? YES ^ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION4 PLEASE CALL US AT (8121) 32ti-3979 - ~~-~l~RjFr Pa S~oR / ~ ~ Fl Inspector (Please Print) Fire Prevention / 1" In / Shift of SNe/Station it -~I White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2048 (Rw. 02105) ,. ~ :, + ADVANCE BEVERAGE CO INC _____________________________ SiteID: 015-021-000298 + Manager Location: 5200 DISTRICT BLVD City BAKERSFIELD BusPhone: (661) 833-3783 Map 123 CommHaz Low Grid: 15D FacUnits: 1 AOV: CommCode: BFD STA 13 EPA Numb: SIC Code:5149 DunnBrad: Emergency Contact / Title Emergency Contact / Title WILLIAM K LAZZERINI / PRESIDENT JERRY MASON / OPERATIONS MGR Business Phone: (661) 833-3783x103 Business Phone: (661) 833-3783x165 24-Hour Phone (661) 834-5485x 24-Hour Phone (661) 871-7431x Pager Phone •: ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact Phone: (661) 833-3782x MailAddr:-PO BOX 9517 State: CA City BAKERSFIELD Zip 93313 Owner WILLIAM K LAZZERINI JR Phone: (661) 834-5485x Address 7609 CALLE CERCA State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: ~ Emergency Directives: ~ PROG A - HAZMAT PROG H - HAZ WASTE GEN 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 a d complete. ' s ~ ~~ V Signature ate FNj~ /~N ~8~0 06 0~~ ~~o\$` 5`~~ -1- 03/14/2006 • ~~. ~~~ Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST 'Environmental Services ~~` '~ '~' 900 Truxtun Ave., Suite 210 SECTION 1 Business .Plan and Inventory Program Bakersfield, CA 93301 Tel: (661) 326-3979 _ __ _ _ FACILITY NAME INSPECTION DATE INSPECTION TIME _ _ __ --------- .dr~.N_c~c_d_.~~v~~?A-~~-- __ _a!~r°Ah!~x--.__.-~/~--.-- . ___ --_.- -~l~~a,r' --- -~~ 1M111 ADDRESS PHONE No. No of Employee{ FACILITYCONTACT Business ID Number ~/r~- ~? Asa V 15-021- ©ooa 9 8 Section 1: Business Plan and Inventory Program 'Routine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection • -- - - _ .. .. _-._. _- ...-......I_._._--- ----.. -- - ----.._ _-_ __. -_..._ _ _. _ _ - -...___ _ __--- - .----- _.. ^ SITE DIAGRAM ADEQUATE ~ ON HAND ANY HAZARDOUS WASTE ON SITE?: ^ YES ^ NO EXPLAIN: • QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~F>s'I ~ 326-3g7g _---~,~~~~s-~-y~a~ _ -------_ _L3-~----------- ---- - - --- Inspector (Please Print) Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow -Station Copy ~ ~ ~ Q~Rti_ sv_c?_ _ Busiri8ss Site Respo ible Party (Please Print) Pink -Business Copy