The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLANDAL-TILE ,.~2 6720 DISTRICT BLVD. ,~ _ . f \. 1 _ ..S DAL TILE SiteID: 015-021-001992 Manager ERIC ABSHIRE Location: 6720 DISTRICT BLVD City BAKERSFIELD BusPhone: (661) 834-6714 Map 123 CommHaz Extreme Grid: 16D FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title ERIC ABSHIRE / MANAGER ROBERT CULLIGAN / WAREHOUSE SUPR Business Phone: (661) 834-6714x Business Phone: (661) 834-6714x 24-Hour Phone (661) 201-1476x 24-Hour Phone (661) 201-1512x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact ERIC ABSHIRE Phone: (661) 834-6714x MailAddr: 6720 DISTRICT BLVD State: CA City BAKERSFIELD Zip 93313 Owner DAL TILE CORP Phone: (661) 834-6714x Address PO BOX 170130 State: TX City DALLAS Zip 75217-0130 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ~ d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT ENT'D J U ~. 2 3 2007 E3ased on my inquiry of those individuals responsible far ou#aining the information, I certify under penalty of lain; that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. t ~ --'~ Signatu e pa ~ -1- 07/11/2007 F DAL TILE SiteID: 015-021-001992 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE E F P IH G 8150.00 FT3 Hi MASTIC F DH L 336.00 GAL Mod MORTAR IH S 45000.00 LBS Min GROUT IH S 12000.00 LBS UnR -2- 07/11/2007 -3- 07/11/2007 F DAL TILE SiteID: 015-021-001992 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE W SIDE OF N ROLL-UP DOOR CAS# 74-98-6 ~GaSATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Ambient FIXED PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest C1360100rFT3 Daily8150100m FT3 I Daily5000r00e FT3 rui~r~tu~vu~ wlnr~lvl;ly 1 a °sWt. RS CAS# 100.00 Propane Yes 74986 t1AGFll[L A~~J;~~1~1~1V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME MASTIC Days On Site 365 Location within this Facility Unit Map: Grid: ENDS OF STOCK RACK CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~ Ambient ~ Ambient ~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 3.50 GAL 336.00 GAL 168.00 GAL tl['~GLiCC1JVU.~ LV1"lYV1V1i,1V1~7 ~Wt. RS CAS# Ethylene Glycol No 107211 Petroleum Distillate, Straight Run Middle No 8030306 t1AGFitC1J A~~JJ~~1~1J;N'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod -4- 07/11/2007 F DAL TILE SiteID: 015-021-001992 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME MORTAR Days On Site THIN SET 365 Location within this Facility Unit Map: Grid: E OF ROLL-UP DOOR N WALL CAS# 65997-15-1 ~SolidE I Mixture~~ PRESSURE TEMPERATURE CONTAINER TYPE I Ambient ~ Ambient BAG AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 LBS 45000.00 LBS 30000.00 LBS - riAGHKLVUJ 1:V1~lYV1VL'1V75 %Wt. RS CAS# 30.00 Silica, Crystalline No 7631869 30.00 Portland Cement No 65997151 t1HGHtCL 1~.7 .7~.7.71~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Min ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME GROUT Location within this Facility Unit INSIDE E WALL Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# ~SolidE TMixtur~mbient~E ~ AmbientT~E BAG CONTAINER TYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 LBS 12000.00 LBS 8500.00 LBS - HAZARDOUS COMPONENTS %Wt• RS CAS# Silica Flour No 7631869 Portland Cement No 65997151 Titanium (IV) Oxide No 13463677 Iron Oxide, Magnetic No 1309371 nr~c~r-u~L i-, a~r~a~i•i~ly 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR -5- 07/11/2007 P DAL TILE SiteID: 015-021-001992 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/07/2006 ~ WE HAVE ALL BEEN TRAINED IN PROPER EMERGENCY NOTIFICATION BY CALLING 911 WITH ONE OF THE MANY PHONES AVAILABLE IN THE OFFICE OR BACK WAREHOUSE. Employee Notif./Evacuation 10/19/1999 ALL EMPLOYEES ARE AWARE OF AND MAP IS POSTED FOR ALL EVACUATION PROCEDURES AND WHERE TO MEET AFTER EVACUATION. Public Notif./Evacuation 04/07/2006 MANAGERS RESPONSIBILITY OR WHOMEVER MAY BE WORKING WITH THAT CUSTOMER AT THE TIME OF THE EMERGENCY TO MAKE SURE THEY ARE SAFE AS WELL. Emergency Medical Plan 04/07/2006 GET WHOMEVER MAY BE INJURED TO MERCY SOUTHWEST, EITHER BY CALLING 911 FOR AMBULANCE, IF SEVERE, OR BY FASTEST AND MOST AVAILABLE WAY IF PERSON IS LESS SEVERE. -6- 07/11/2007 F DAL TILE SiteID: 015-021-001992 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/19/1999 ~ WE KEEP OUR PROPANE TANKS NOT IN USE CHAINED UP IN OUTSIDE LOT BEHIND BLDG. Release Containment 04/07/2006 WE KEEP ALL POWDER AND LIQUID MATERIALS IN SAME GENERAL AREA AT ALL TIME FOR EASY ACCESS OR CLEAN-UP. Clean Up 10/19/1999 WE SWEEP UP ALL BAGGED POWDER PRODUCTS WITH CLEAN SWEEP MATERIAL AND THROW IN TRASH. V1.11G1 iCCaUU1uc til:l.lVdl.1U11 -7- 07/11/2007 F DAL TILE SiteID: 015-021-001992 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~JCC:1d1 !1d'GdLUb' Utility Shut-Offs A) GAS - OUTSIDE BLDG BEH SITE B) ELECTRICAL - STORAGE RM E SIDE OF BLDG C) WATER - MAIN FIRE SPRINKLER SHUT-OFF IN STORAGE RM D) SPECIAL - NONE E) LOCK BOX - NO 01/30/2007 Fire Protec./Avail. Water 01/30/2007 PRIVATE FIRE PROTECTION - FIRE SPRINKLERS. NEAREST FIRE HYDRANT - 2 ACROSS ST S SIDE OF DISTRICT BLVD. Building Occupancy Level 04/07/2006 9 EMPLOYEES -8- 07/11/2007 aS•, ...o ~.~ F DAL TILE SiteID: 015-021-001992 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/26/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WE PERFORM NEW EMPLOYEE AND ANNUAL HAZMAT TRAINING AND EMERGENCY EVACUATION PLAN TRAINING. ruyC ~ nGiu 1VL 1'UI.uIC VAC L1Glu 1V1 L' Ul.u1C Ve7-C -9- 07/11/2007 .~ + DAL TILE ________________~.__________________________= SiteID: 015-021-001992 + Manager ERIC ABSHIRE Location: 6720 DISTRICT BLVD City BAKERSFIELD BusPhone: (661) 834-6714 Map 123 CommHaz High Grid: 16D FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / ",~'itle Emergency Contact / Title ERIC ABSHIRE / MAI~~t.GER ROBERT CULLIGAN / WAREHOUSE SUPR Business Phone: (661} 834-6714x Business Phone: (661} 834-6714x 24-Hour Phone (661) 3/x 24-Hour Phone (661) ~~x Pager Phone ( ) 7~i l -I y"t b x Pager Phone ( ) 2~ \ - 151 Z- x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact Phone: (661) 834-6714x MailAddr: 6720 DISTRICT BLVD State: CA City BAKERSFIELD Zip 93313 Owner DAL TILE CORP Phone: (661) 834-6714x Address PO BOX 170130 State: TX City DALLAS Zip 75217-0130 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: ~ Emergency Directives: ~ PROG A - HAZMAT 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. L~~ Ci(~ Zy Signatu a Date ENT'D APR 0 7 2006 -1- 03/10/2006 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan, and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE No. ~ No. of Employees ZU S~ tS"~ ~c CT ---._ ------ ---------------- FACILITYCONTACT Business ID Number yy~~ (m~ IS-~21- UQ(~')Z Section 1: Business Plan and Inventory Program 'Routine ^ Combined ^ Joint Agency ^MuIti-Agency ^ Complaint ^ Re-inspection C V \V=Vioatlonn~l OPERATION ^ APPROPRIATE PERMIT ON HAND COMMENTS (~ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS r~ ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ f ROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF HAT MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION -~ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES EXPLAIN: .. 5. ~,~ ~ Cam`," *~-. NO ...: ; ~_z- QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~66'I ~ 326-3979 ----- - ------._ .. ---- ... _.. _- -._...Q -- ~ ~ --------- Inspector Badge No. Business Site Responsible Party While - Envvonmental Services Yellow - Statbn Copy Pink -Business Copy UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT Prevention Services e art a ~~tl 900 Truxtun Ave., Suite 210 ~wrr r Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~' - ~ c' NSPECTION ATE INSPE TION TIME !d /g o S ADDRESS 7 ~q g~ _ G rjO ~/ ~r~ HONE O. O OF EMPLOYEES ~ ^ ~~ FACILITY CONTACT ~~i ~ ~ ` ~ / ~~ 6 USINESS ID NUMBER ~~ 15-021- O6` Section 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 ^ BUSIt12SS PLAN CONTACT INFORMATION ACCURATE N~ ~ /~ P^! 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 P OCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE ~ ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ~~~ EXPLAIN: ._ \... QUESTIONS REGAR I THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~~ ~~ nspector (Plea Print) F revention / 1b' In /Shift of Site/Station # B-usiness White -Prevention Services Yellow -Station Copy pink -Business Copy FD2049 (Rev. 02105) DAL TILE SiteID: 015-021-001992 Manager ERIC ABSHIRE Location: 6720 DISTRICT BLVD City BAKERSFIELD BusPhone: (661) 834-6714 Map 123 CommHaz Extreme Grid: 16D FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title ERIC ABSHIRE / MANAGER ROBERT CULLIGAN / WAREHOUSE SUPR Business Phone: (661) 834-6714x Business Phone: (661) 834-6714x 24-Hour Phone (661) 201-1476x 24-Hour Phone (661) 201-1512x Pager Phone ( ) - x Pager Phone ( ) - x .............. Hazmat Hazards: Fire Press ImmHlth DelHltli ............. Contact ~iC, ~JS~~- Phone: (661) 834-6714x MailAddr: 6720 DISTRICT BLVD State: CA City BAKERSFIELD Zip 93313 Owner DAL TILE CORP Phone: (661) 834-6714x Address PO BOX 170130 State: TX City DALLAS Zip 75217 -0130 Period to TotalASTs: _ dal Preparers TotalUSTs: = Coal Certif'd: RSs: No ParcelNo: ............. Emergency Directives: PROG A - HAZMAT E3ased on my inquiry of those individuals responsible for obtaining the information, I certify ~N~p~ ~ ~ ® ~ G ~i ~~~~ under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurat and complete. ~~~ - ~~~ Signature Date -1- 01/30/2607 ?, F DAL TILE ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-001992 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit NYCP ............. PROPANE E F P IH G 8150.00 FT3 ~f MASTIC F DH L 336.00 GAL 1WIod MORTAR IH S 45000.00 LBS lain GROUT IH S 12000.00 LBS UiR -2- 01/30/2007 -3- O1/30/Zb07 F DAL TILE SiteID: 015-021-001992 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: --- OUTSIDE W SIDE OF N ROLL-UP DOOR CAS# 74-98-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient FIXED PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1360.00 FT3 8150.00 FT3 5000.00 FT3 HALAllDOUS COMPONENTS "" %Wt. RS CAS# 100.00 Propane Yes 749$6 rit~GHKL f-~J ~7L'.7J1~1L"1V1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MC$ No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME MASTIC Days On Site 365 Location within this Facility Unit Map: Grid: --- ENDS OF STOCK RACK CAS# Liquid TMixture ~mbient~E ~ AmbientT~E -TPLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 3.50 GAL 336.00 GAL 168.00 GAL ruyc~rucLV~a ~vrtrvlv~lvlJ %Wt• RS CAS# Ethylene Glycol No 107211 Petroleum Distillate, Straight Run Middle No 8030306 11CiGL'l.RL tiJ JL' ~7.71•i~1V 1 A TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCA No No No No/ Curies F DH / / / Mdcl -4- 01/30/2007 F DAL TILE ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME MORTAR THIN SET Location within this Facility Unit E OF ROLL-UP DOOR N WALL STATE TYPE PRESSURE Solid TMixture~mbient SiteID: 015-021-001992 ~ Facility Unit: Fixed Containers at Site ~ ............. Days On Site 365 Map: Grid: CAS# 65997-15-1 TEMPERATURE CONTAINER TYPE Ambient BAG AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 LBS 45000.00 LBS I 30000.00-___LBS - t1HGL-~iCLVUA lLV1~lYV1V~1V1~ -- oWt. RS CAS# 30.00 Silica, Crystalline No 7631869 30.00 Portland Cement No 65997151 tYEiGKKL L-~~JJt5aJ1~1tS1Vl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Mini ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME GROUT Location within this Facility Unit INSIDE E WALL STATE TYPE PRESSURE Solid TMixtur~ Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: --- CAS# TEMPERATURE CONTAINER TYPE -"" Ambient BAG AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 LBS 12000.00 LBS 8500.00 LBS nx~r-~1c~VUa ~vrirviV~ivla oWt. RS CAS# Silica Flour No 7631869 Portland Cement No 65997151 Titanium (IV) Oxide No 13463677 Iron Oxide, Magnetic No 130971 riHGl-1KL 1-~ J,7~J JL~1~1V 1 5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UriR -5- 01/30/2007 F DAL TILE SiteID: 015-021-001992 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/07/20175 ~ WE HAVE ALL BEEN TRAINED IN PROPER EMERGENCY NOTIFICATION BY CALLING 911 WITH ONE OF THE MANY PHONES AVAILABLE IN THE OFFICE OR BACK WAREHOUSE. Employee Notif./Evacuation 10/19/1995 ALL EMPLOYEES ARE AWARE OF AND MAP IS POSTED FOR ALL EVACUATION PROCEDURES AND WHERE TO MEET AFTER EVACUATION. Public Notif./Evacuation 04/07/2006 MANAGERS RESPONSIBILITY OR WHOMEVER MAY BE WORKING WITH THAT CUSTOMER AT THE TIME OF THE EMERGENCY TO MAKE SURE THEY ARE SAFE AS WELL. Emergency Medical Plan 04/07/2005 GET WHOMEVER MAY BE INJURED TO MERCY SOUTHWEST, EITHER BY CALLING 911 FOR AMBULANCE, IF SEVERE, OR BY FASTEST AND MOST AVAILABLE WAY IF PERSON IS LESS SEVERE. -6- 01/30/2007 F DAL TILE SiteID: 015-021-001992 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/19/1995 ~ WE KEEP OUR PROPANE TANKS NOT IN USE CHAINED UP IN OUTSIDE LOT BEHIND BLDG Release Containment 04/07/2006 WE KEEP ALL POWDER AND LIQUID MATERIALS IN SAME GENERAL AREA AT ALL TIME Ft~Ft EASY ACCESS OR CLEAN-UP. Clean Up 10/19/1995 WE SWEEP UP ALL BAGGED POWDER PRODUCTS WITH CLEAN SWEEP MATERIAL AND THROW IN TRASH. Vl,i1Cl tC~SUUIC:~ HLl.1VaL10I1 -7- 01/30/2007 F DAL TILE SiteID: 015-021-001992 ~ Fast Format ~ ~ Site Emergency Factors Overall Sites ~ .7~JCC:1d1 ridGdLC,1.5' Utility Shut-Offs O1/30/20t~`7 A) GAS - OUTSIDE BLDG BEH SITE B) ELECTRICAL - STORAGE RM E SIDE OF BLDG C) WATER - MAIN FIRE SPRINKLER SHUT-OFF IN STORAGE RM D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water Ol/30/20C7'7 PRIVATE FIRE PROTECTION - FIRE SPRINKLERS. NEAREST FIRE HYDRANT - 2 ACROSS ST S SIDE OF DISTRICT BLVD. Building Occupancy Level 04/07/20F75 9 EMPLOYEES -8- 01/30/2007 F DAL TILE SiteID: 015-021-001992 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/26/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WE PERFORM NEW EMPLOYEE AND ANNUAL HAZMAT TRAINING AND EMERGENCY EVACUATION PLAN TRAINING. rciyC ~ 1ZC 1lA LVL i'UI. LLLC VuC i1C 11..1 LVL 1'UI.ULC V5C -9- 01/30/2007 Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST H ~ e. R s F , 0 9oo'Pruxfun Ave., Suite 210 ,::.~~ _,~ .~~.~:- - ..u~T..µa,:~-- ~.._ Fi;RE _ Bakersfield, CA 93301_ _ SECTION "'I : BUSI11@SS Plan'and Inv@ntOry Program aer~ Tel.: (661) 326-3979 • ~ Fax: (661) 872-2171 i~ ~ J FACILITY NAME p\ INSPECgTI~O7N DyAT~E INSPECTION TIME ADDRESS °~ C !' / PHONE NO. l ~' ~ O OFEMPLOYEES FACILITY CONTACT //VV f ~~ ~ C~ it / / ~+'~ i h BUSINESS ID NUMBER 15-021- 00 ~,~lgZ ~. V -_ _ Section 1: Business Plan and Inventory Program ~~ L1' ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPE ION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSInG'SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~ ~ 1" ~ /~ J ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ 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 HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 `~~~ -~ ~~~ ~ 3 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # ^ YES i~NO White - Prevention.Services Yellow -Station Copy Pink -Business Copy _ FD 2155 (Rev. 09/05